Cone-beam CT-guided root uprighting of a severely angulated impacted maxillary canine using a boot loop and...

Orthodontic traction of impacted maxillary canines remains a clinical challenge, particularly when the tooth is severely angulated. Conventional force application to the crown may increase the risk of damage to adjacent roots due to insufficient control of root positioning. This case demonstrates the use of a boot loop in combination with a micro-screw to upright the canine root within the alveolar bone before potential root contact. Treatment alternatives and biomechanics are discussed to illustrate the effectiveness of this approach.Diagnosis and treatment plan:A boy aged 14 years 1 month presented with a severely angulated impacted maxillary left canine, with the root apex located above the maxillary left second premolar. The primary treatment objective was to align the impacted canine while preventing injury to adjacent roots. The treatment plan involved uprighting the canine root using a boot loop and micro-screw designed to apply light, controlled forces through loop activation.

During active treatment, the root angulation of the impacted canine was corrected from 60° distal to 13° mesial, achieving a maximum angular change of 73° through controlled uprighting. The canine was then successfully repositioned into its ideal position. No root resorption, gingival recession, or loss of supporting tissue was observed.

The combination of a boot loop and micro-screw offers effective three-dimensional control of crown and root movement, providing a reliable and effective solution for managing severely angulated impacted canines.