Combination of Surgical exposure and fixed orthodontic appliance as bilateral impacted canine correction

Dr. drg. Tita Ratya Utari, Sp.Ort
Email: tita_utari@yahoo.com

drg. Edwyn Saleh
Email: edwin@fk.umy.ac.id

Combination of Surgical Exposure and Fixed Orthodontic
Appliance as Bilateral Impacted Canine Correction
1

Tita Ratya Utari , Edwyn Saleh

1

1

Lecturer of School of Dentistry, Faculty of Medicine and Health Science Universitas Muhammadiyah Yogyakarta

Introduction

Result


Case Report

Canine has high prevalence to be

18 years old patient complaining protuded and crowding of

impacted after wisdom teeth because

upper jaw. Clinical examination revealed persistence of upper

of several reasons. However It has

deciduous canine. The permanen canine was impacted with an

major

and

unfavorable inclination that may not support spontaneous


aesthetics, so it is necessary to retain

eruption, even if decidous canine has extracted. Midline was

permanent

shifted 1,5mm to the right towards upper jaw. Molar relation

role

in

jaw

function

canine in oral cavity.

Impacted canine widely treated by

surgical

exposure

followed

Anterior
crowding
and midline shifting was
corrected in two years
completed
with
full
eruption of permanen
canine.

right and left were class I. Overjet and overbite were nomal.

with


orthodontic retraction.

Aim
To explain management of bilateral
impacted permanent canine related to
deciduous persistence.

Figure 3. Post–treatment
Figure 1. Pre–treatment

Discussion

Case Management




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.





Open flap was achieved by full thickness triangular flap

If it’s possible, extraction of the ca-

to expose the canine continue with braces installation.

nines should be avoided because maxil-

Canine was retracted to reached complete eruption that

lary permanent canines are important for


has done in three months.

an attractive smile and also essential for

Upper jaw protrution was corrected by extracting four

a functional occlusion (Vaida et al, 2014;

first premolar and anterior tooth retraction.

Aksu et al, 2006). Untreated impacted canines may cause arch length discrepancies, loss of vitality of adjacent teeth, follicular 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

Figure 2. Surgery Treatment


Conclusion

References

Bilateral impacted permanent
canine

can

be

treated

by

surgical

exposure

and


orthodontic

management

that

result an optimum function and
aesthetics.

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 Report).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
Straightwire and Cantilever Mechanics: A Case Report. Hindawi Publishing Corp. Case Reports in Dentistry. 2014:1-9