Sequential traction of a labio-palatal horizontally impacted maxillary canine with a custom three-directional force device in the space of a missing ipsilateral first premolar

Abstract

Orthodontic treatment is more complicated when both soft and hard tissues must be considered because an impacted maxillary canine has important effects on function and esthetics. Compared with extraction of impacted maxillary canines, exposure followed by orthodontic traction can improve esthetics and better protect the patient's teeth and alveolar bone. Therefore, in order to achieve desirable tooth movement with minimal unexpected complications, a precise diagnosis is indispensable to establish an effective and efficient force system. In this report, we describe the case of a 31-year-old patient who had a labio-palatal horizontally impacted maxillary left canine with a severe occlusal alveolar bone defect and a missing maxillary left first premolar. Herein, with the aid of three-dimensional imaging, sequential traction was performed with a three-directional force device that finally achieved acceptable occlusion by bringing the horizontally impacted maxillary left canine into alignment. The maxillary left canine had normal gingival contours and was surrounded by a substantial amount of regenerated alveolar bone. The 1-year follow-up stability assessment demonstrated that the esthetic and functional outcomes were successful.

Caninos impactados. Una revisión de la literatura moderna

“…Tambien nos informan que se encontró un movimiento radicular que va desde los 0.4mm a 0.8mm por mes, mientras que el movimiento coronal del canino impactado iba en promedio desde 1.08mm y 1.96mm por mes (Migliorati, 2021;Servais, 2018). La elección de la tracción ortodoncia es sinónimo de un tratamiento optimo, evitando la extracción completa del diente impactado (Yang, 2019).…”

“…La impactación dental es la pérdida parcial o total de la emergencia del diente, que ocurre después de la edad cronológica ideal de erupción, como consecuencia de diversos factores locales, tales como: obstrucción mecánica (quistes, tumores o dientes), espacio insuficiente en las arcadas dentarias, pérdida prematura de órganos dentales deciduos, discrepancia de tamaño entre el diente y el arco, entre otras (Jacoby, 1983;McBride, 1979;Yang, 2019).…”

The Relationship between Unilateral Palatal Maxillary Canine Impaction and the Morphology of the Maxilla: A CBCT Study in Eastern Province of Saudi Arabia

“…The palatal vault depth was recorded as the vertical distance from the deepest point on the palatal vault to the horizontal contact line between the right and left first maxillary molars (►Fig. 1). The width of the nasal cavity was recorded at the broadest part of the lower third of the nasal cavity in the coronal section of the CBCT image.…”

“…Maxillary canines are considered vital teeth in maintaining oral function, stability, and aesthetics. 1 The mean age of maxillary canine eruption is between 11 and 12 years for girls and between 12 and 13 years for boys. 2 Teeth eruption is a physiological process; however, occasionally a fully developed tooth remains embedded within soft or hard tissue after its natural eruption stage has passed, and it is considered impacted.…”

Traction of impacted and stacked maxillary anterior teeth with precise biomechanics followed by torque control using gate spring

“…23 Because traction force can only be applied to the crown and rarely to the root (except in the patient reported by Arango et al 24 ), extra torque control is commonly required in impaction patients when the crown has been aligned while the root lags. A plethora of torque control methods have been introduced into the treatment of impacted anterior teeth, including inverted brackets, 25 a high-torque prescription bracket with L-loop, 19 auxiliary brackets bonded on the gingival one third of crowns of the adjacent teeth with a segmental archwire, 20 Warren Spring, 20 temporary anchorage device, 24 and so on. However, torque discrepancy can scarcely be eradicated.…”