Multispecialty team management of a case with impacted maxillary permanent canines

A fifteen-year-old Chinese girl presented with unerupted maxillary permanent canines impacted against the roots of the central incisors, causing malalignment of the maxillary incisors. The canines were fully formed and their apices closed. The potential path of eruption of the canines contraindicated surgical exposure, followed by orthodontic traction. It was decided to transplant the impacted canines to their normal positions, and then align the maxillary anterior teeth, using a fixed orthodontic appliance. The transplantations and the orthodontic treatment were successful, and neither transplant showed signs of root resorption, periodontal pockets, mobility, or pain, three years after surgery. Root canal therapy was performed on the canines after transplantation, because their apices were closed. They were stained by the amalgam in the access cavities, but both responded well to nonvital bleaching using 30 percent H2O2.