Vu Orthodontics - Orthodontist - Braces  & Invisalign

Impacted Canines

With impacted canines, the following considerations are important: surgical, periodontal, and orthodontic. There are differences in the surgical management of the labially and palatally impacted canines.  In addition, there are different methods of attachment to the canine (right after the surgical exposure) for orthodontic forced extrusion.  Although canines should be saved because they are the corners of the mouth, the extraction of a canine may be indicated in some rare instances. Various factors that influence the decisions must be evaluated thoroughly.

Example

The following is an example of the surgical exposure and forced eruption of impacted canines. 

Case 1- Labially Impacted Canine  14 y.o. female, laser surgical exposure and forced eruption of impacted upper left canine.

The initial status of the impacted upper left canine are shown in Figs. 1 & 2.

Fig. 1 Initial panoramic radiograph (cropped) of impacted upper left canine

Fig. 2 Initial photograph of impacted upper left canine (no palatal bulging)

Without surgical exposure and forced eruption, there was practically very little progress with natural eruption of the upper left canine for nearly 2 years (not shown).  With the surgical exposure (laser -> no bleeding) and forced eruption, the progress can be seen almost immediately - within a month (Figs. 3-5), and a complete success in four months (Fig. 6).

Fig. 3 Right after laser surgery: no bleeding

Fig. 4  Four days after laser surgery: well healing

Fig. 5  One month after surgery: good eruption of canine

Fig. 6  Four months after surgery: the canine has been completely brought into the arch

Case 2 - Palatally Impacted Canine  12 y.o. female, laser surgical exposure and forced eruption of impacted upper right canine.

The initial status of the impacted upper right canine are shown in Figs. 7 & 8.

Fig. 7 Initial panoramic radiograph (cropped) of impacted upper right canine

Fig. 8 Initial photograph of impacted upper right canine (palatal bulging)

Without surgical exposure and forced eruption, there was practically very little progress with natural eruption of the upper right canine for nearly 3 years (not shown).  With the surgical exposure (laser -> no bleeding) and forced eruption, the progress can be seen almost immediately - within a month (Fig. 9).  After 2 months, the crown is more visible: part of the crown can be seen clearly (Fig. 10).

Fig. 9 One month after laser surgery: good progress for forced eruption (as well as good healing)

Fig. 10 Two months after laser surgery: good progress for forced eruption