Clinical Outcome of an Impacted Maxillary Canine: From Exposition to Occlusion

The aim is to report a case of impacted maxillary right canine successfully positioned into the occlusion line.

Although the treatment of choice for an impacted canine is a combined surgical-orthodontic approach, there are differences in technique. The preorthodontic uncovering and autonomous eruption technique is a safe and predictable option for the treatment of palatally impacted maxillary canines in adolescents and adults as is the orthodontic creation of a space before minimal surgical exposure, the bonding of a small attachment (an eyelet), full-flap closure, and immediate traction. Although the mechanical management of impacted teeth is a routine task for most orthodontists, certain types of impaction can be frustrating.

An 18-year-old adult patient presented for clinical examination with a mobile maxillary right deciduous canine, the absence of a maxillary right permanent canine, Angle Class I malocclusion, an overjet of 2.0 mm, an overbite of 3.0 mm, and rotated canine and left maxillary central and lateral incisors. Cephalometric measurements revealed a skeletal Class I relationship as well as upright maxillary incisors (1. NA = 18°) and mandibular incisors (1. NB = 16°, IMPA = 80°). The facial profile was concave. Clinically, a constricted maxillary arch was observed, and the patient had a nail-biting habit.

The canine was aligned, leveled and positioned in the occlusion line. The esthetic, functional and periodontal results remained stable in the retention phase.

Various treatment strategies are available to treat impacted maxillary canines. The surgical, periodontal, and orthodontic considerations in the management of impacted canines must be clearly explained to the patient.