Orthodontic treatment of palatally impacted maxillary canines

The aim of this study was to determine the feasibility of treating children with impacted maxillary canines by orthodontic treatment alone. The subjects were 28 children (mean age: 13.5 years, range 11.4-16.1 years) with between them 32 palatally impacted canines. The overlying primary canines were extracted between 0 and 42 months before the start of appliance treatment to open space in the arches for the impacted teeth. No other surgical procedures were carried out prior to the start of appliance treatment. Appliance treatment was deferred for at least six months if an impacted canine was the main reason for treatment, otherwise treatment was commenced according to the needs of the patient. In 94% of the cases, the severity of impaction lessened following extraction of the overlying primary canines and orthodontic treatment. The deepest impactions tended to occur in the oldest children. The majority (75%) of the canines emerged following orthodontic treatment to create space for them in the arch; the remainder were surgically exposed. Appliance treatment tended to take longer in children with the deepest impactions. It is concluded that fixed appliance treatment to create space for a palatally impacted canine is an effective management option for children with impacted maxillary canines.