Guided eruption of an impacted maxillary right canine: a multidisciplinary case report

Maxillary canine impaction is a relatively common eruption disturbance that can compromise smile esthetics and functional occlusion. Successful management of impacted canines often requires a multidisciplinary approach combining surgical exposure, orthodontic traction, and radiographic monitoring. A 16-year-old girl presented with a chief concern of dissatisfaction with her smile esthetics. Clinical and radiographic evaluations revealed a palatally impacted maxillary right canine and a retained primary maxillary right canine, which was subsequently extracted. Orthodontic treatment was initiated to create adequate space for eruption of the impacted tooth. Following conservative surgical exposure from the palatal aspect, an orthodontic button with an elastic chain was bonded to the exposed crown. Light continuous forces were applied to gradually guide the tooth into the dental arch. Periodic cone beam computed tomography (CBCT) confirmed favorable tooth movement and the absence of resorption of adjacent roots. The multidisciplinary approach demonstrated in this case--integrating surgical exposure, orthodontic biomechanics, and CBCT monitoring--allowed for controlled eruption of the impacted canine with maintenance of bone integrity, resulting in esthetic improvement.