[Skeletal anchorage: use of miniscrews for impacted maxillary canine management]

Impaction of maxillary canines is a frequently encountered clinical problem. Patients' refusal to a long orthodontic treatment or ankylosis of the impacted tooth results in various treatment difficulties. The aim of this study was to evaluate the possible role of miniscrews in the management of impacted upper canines. In a series of 28 consecutive patients with a total of 31 impacted maxillary canines (12 men and 16 women aged from 14 to 63 years, mean 24 years), each impacted tooth was surgically exposed and an attachment was bonded. An intraosseous screw (1.5 mm in diameter and 8-10 mm long) with an endosseous body and intraoral neck section was inserted into the premolar-molar interradicular space. Following soft tissue healing, orthodontic traction was initiated. After correction of the angulation of the canine, the mini-screw was removed and traditional orthodontic therapy was completed. Twenty-seven canines were extruded successfully (87%), the duration of the orthodontic treatment with fixed appliances was decreased. In the 3 cases that failed due to ankylosis, the skeletal anchorage spared the patients and the clinicans the disappointment of a long-term unsuccessful traditional orthodontic treatment. In one patient, the mini-screw was removed because of inflammation and pain before the beginning of the orthodontic traction. This study shows that mini screw anchorage should be taken into consideration when extrusion of an impacted canine is planned.