Combination of Surgical Exposure and Fixed Orthodontic
Appliance as Bilateral Impacted Canine Correction
Tita Ratya Utari
1
, Edwyn Saleh
1
1
Lecturer of School of Dentistry, Faculty of Medicine and Health Science Universitas Muhammadiyah Yogyakarta
Introduction
Canine has high prevalence to be impacted after wisdom teeth because of several reasons. However It has major role in jaw function and aesthetics, so it is necessary to retain permanent canine in oral cavity. Impacted canine widely treated by surgical exposure followed with orthodontic retraction.
Aim
To explain management of bilateral impacted permanent canine related to deciduous persistence.
Case Report
18 years old patient complaining protuded and crowding of upper jaw. Clinical examination revealed persistence of upper deciduous canine. The permanen canine was impacted with an unfavorable inclination that may not support spontaneous eruption, even if decidous canine has extracted. Midline was shifted 1,5mm to the right towards upper jaw. Molar relation right and left were class I. Overjet and overbite were nomal.
Orthodontic treatment was done by fixed appliance with
Straight Wire system slot 0.22.
Leveling and aligning using Niti wire 0.14 followed by NiTi
0.18.
Crowding has been corrected after 7 months and serve
available space for canine eruption.
Figure 1. Pre–treatment
Figure 2. Surgery Treatment
drg. Edwyn Saleh
Email: edwin@fk.umy.ac.id
Dr. drg. Tita Ratya Utari, Sp.Ort Email: tita_utari@yahoo.com
Conclusion
Bilateral impacted permanent canine can be treated by
surgical exposure and
orthodontic management that result an optimum function and aesthetics.
Figure 3. Post–treatment
Case Management
Result
Anterior crowding
and midline shifting was corrected in two years completed with full eruption of permanen canine.
Open flap was achieved by full thickness triangular flap
to expose the canine continue with braces installation.
Canine was retracted to reached complete eruption that
has done in three months.
Upper jaw protrution was corrected by extracting four
first premolar and anterior tooth retraction.
Discussion
References
If it’s possible, extraction of the ca-nines should be avoided because maxil-lary permanent canines are important for an attractive smile and also essential for a functional occlusion (Vaida et al, 2014; Aksu et al, 2006). Untreated impacted ca-nines may cause arch length discrepan-cies, loss of vitality of adjacent teeth, fol-licular cysts, canine ankylosis, infections, and pain (Paduano, 2014). In this case surgical exposure of the canine with open flap by full thickness triangular flap and followed by orthodontic treatment to bring the tooth into the line of occlusion is the most appropriate approach
1.Vaida L, Todor B, Corega C, Baciut M, Baciut G. A Rare case of Canine Anomaly – a possible Algorithm for Treating it. Rom J Morphol Embryol 2014, 55(3 Suppl):1197–1202
2.Aksu M, Taner T. The Treatment of a Palatally Impacted Maxillary Canine by Tunnel Traction Method. Olgu Raporu (Case
Re-port).2006;30;2:48-58
3.Paduano S, Cioffi I, Iodice G, d’Anto V, Riccitiello F, Pellegrino G, Valletta R. Correction of Multiple Canine Impactions by Mixed
