Orthodontic Intervention to Impacted and Transposed Lower Canines

Abstract

Impacted and transposed teeth cause serious difficulties in tooth eruption and movement as well as esthetic and functional outcomes. Proper treatment planning including good biomechanical control is essential in order to avoid side effects during traction and aligning of the impacted and/or transposed teeth. The purpose of the present study was to present a successfully treated female patient having transposed and impacted lower canines by means of a modified lingual arch and fixed orthodontic appliance. A female patient aged 13 years and 9 months presented to the orthodontic department with a chief compliant of bilateral spacing and missing teeth in mandibular dentition. After leveling and creating sufficient space in the mandibular arch for the canines, a modified lingual arch was cemented to the mandibular first molars. The lingual arch had two hooks extending to the distobuccal areas of the canine spaces. Elastic chains were applied between the hooks on the lingual arch and the ligatures tied to the attachments on the canine crowns. The light forces generated by elastic materials caused impacted canines to erupt and tend towards their own spaces in the dental arch. As a result, impacted and transposed lower canines were properly positioned in their spaces, and the treatment results were stable during the retention period.

Orthodontic traction technique: Clinical case report based on literature

“…operative control, as well as patient awareness and collaboration are highly relevant aspects for the success or failure of treatment. In cases of failure, alternative approaches should be brought to the attention of patients, parents and caregivers [8,10].…”

“…According to Bishara, et al [3], the main signs to be observed in the clinical examination are: delay of eruption after the age of 14 years, prolonged retention of primary canines, elevation of the labial or palatal mucosa, distal migration of the upper lateral incisor, with or without deviation of the medium line. Radiographic examination is essential in the radiographic elaboration, as it proves the canine impaction and its location in the vestibular-lingual, cervico-occlusal and mesio-distal directions, as well as its relation with adjacent structures [7,8].…”

“…This method allows safer and more accurate planning with respect to orthodontic movement. It has higher image quality than conventional radiographs, however, it still has a high cost and its dose of radiation, relatively high, limits the indications for its use [8].…”

“…The canine impaction is twice as large in females and can be uni or bilateral. Approximately 80.0 to 90.0 % of impacted canines are on the palate and 20.0 % per vestibular [6][7][8]. The dental movements during the eruption are complex and are followed minute by coordination of tooth growth, alveolar process growth and bone growth.…”

Surgical approach of transmigrated mandibular canine preserving midline of the mandibular symphysis: report of a case

“…3,4 Presently, there are several treatment options available to address transmigrated canines, including radiographic observation, autogenous transplantation, orthodontic treatment and tooth extraction when there is inadequate space to realign the tooth. 5 There have been incidences of complications associated with the extraction of impacted teeth like trismus, inflammation, mild to moderate pain, hematoma and bony defects. 6 Different studies have reported that some patients who have been operated on the symphysis, suffered changes in their facial contour and aesthetic changes in the symphysis zone.…”