“Canine First Technique”, An Innovative Approach in Maxillary Impacted Canines: A Case Report

Abstract

Background: Maxillary canine impaction is one of the most challenging issues in orthodontics. The best treatment protocol in these cases is still debated. The purpose of this study is to describe the management of maxillary canine impaction in an adult female patient with the “Canine First Technique”. Case Report: A 21-years-old female attended our dental unit seeking orthodontic treatment. Clinical examination revealed a class II relationship, the persistence of both upper deciduous canines. The panoramic X-ray and Cone Beam Computed Tomography showed bilateral palatal permanent canine displacements and close proximity between crowns of impacted canines and roots of lateral incisors. The canines were disimpacted by means of two cantilevers inserted directly in two Temporary Anchorage Devices placed palatally and when canines were near the crest, the fixed orthodontic treatment was started. Results: At the end of the treatment, canine Class I relationships with torque correction of canines, normal overjet and overbite, and good alignment of dental arches were achieved. The radiographic evaluation showed ideal root parallelism and preserved periodontal health in the canine region. Conclusion: The Canine First Technique could provide some advantages compared to conventional approaches in terms of biomechanics, esthetics, oral hygiene, and risk reduction of root resorption of upper lateral incisors.

Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with “Canine First Technique” and Clear Aligners: A Case Report

“…In this case, the first problem we met, which cannot be solved by aligners on their own, is surgical exposure and traction of the canine. For this reason, the Canine First Technique was used [ 17 ]. Indeed, this approach still ensures the aesthetics that are important in adult patients and offers several other advantages.…”

“…The patient underwent surgery to recover 1.3, in line with the Canine First approach [ 17 ]. Therefore, the 1.3 was surgically exposed by setting up a full-thickness flap and placement of a chain button on the palatal side; then, the flap was sutured, and the traction chain tied to the canine came out from the center of the flap.…”

“…The Canine First Technique consists of an innovative surgical–orthodontic approach for the impacted canine. This procedure provides the disimpaction of the canine, moving the crown away from the roots of adjacent incisors with a cantilever and a skeletal anchorage [ 17 ].…”

Biomechanical Effects of Different Auxiliary–Aligner Designs on the Rotation of an Upper Canine: A Finite Element Analysis of a Specific Patient

“…A skeletal III class with a bi-retrusion and a brachi-facial growth pattern resulted from the cephalometric EBO analysis results (Table 1). In this patient, the treatment plan needed to provide the recovery of the impacted canine: the first step was surgical exposure of the canine crown, then the canine was pulled through a Temporary Anchorage Device (TAD) [24,25]. At first, the canine was surgically exposed then, a miniscrew OrthoEasy ® (FORESTADENT Bernhard Förster GmbH, Pforzheim, Germany) 10 × 1.7 mm was inserted from the palatal side between 1.5 and 1.6, and a Titanium Molibdenum Alloy (TMA) rectangular wire (0.019 × 0.025) was used to shape a lever activated to pull the palatal canine (Figure 3).…”

Canine Impaction: Digital Orthodontic Planning in Conjunction with TADs (Temporary Anchorage Devices) and Aligners

“…The "Canine First Technique", already explained in the literature, is an orthodontic approach for the impacted canines [8,9]. The aim of this technique consists of moving the crown away from the roots of adjacent incisors with cantilever spring and temporary anchorage devices Since the introduction of TADs as anchorage devices, the effectiveness and predictability of orthodontic treatment has improved [10] In the literature, there are many authors who discuss the treatment of impacted canines with conventional fixed appliances, but no studies have been carried out concerning clear aligners.…”