Double-archwire mechanics using temporary anchorage devices to relocate ectopically impacted maxillary canines

This case report introduces a novel double archwire mechanics concept using orthodontic mini-implants and a miniplate to relocate ectopically impacted maxillary canines in a 14-year-old female with a Class III subdivision left malocclusion. The objective of this orthodontic treatment was to salvage the maxillary lateral incisors so they could be used for conservative restorations upon completion of the orthodontic treatment and to guide the impacted maxillary canines to their correct anatomical positions. The authors report that an iatrogenic root resorption of the maxillary lateral incisors, which is caused by a direct root contact between teeth during the active relocating procedure, can be minimized by using double-archwire mechanics. The optimal overbite, overjet, and occlusal interdigitation were achieved after the orthodontic treatment. The facial balance was also improved. Active orthodontic treatment lasted 26 months, and the results remained stable for 13 months after the removal of orthodontic appliances. This report also shows that the gingival margins of the relocated maxillary canines can be established without postorthodontic periodontal procedures when effective orthodontic mechanics are utilized to retain the canines in the alveolar bone and minimize any contact of the roots with gingival tissues during active relocation of the impacted maxillary canines.