13 years old female patient presented with bilateral ectopic canines. Orthodontic treatment by: Dr. Yossi Bar-Zion, DDS, MS. Surgical exposure by: Dr. Jon Nakano, DDS.

Impacted canines can present a series of challenges including delayed eruption, root resorption to adjacent teeth, potential periodontal compromises, arch-length discrepancies, and esthetic as well as functional compromises. There are several treatment approaches to address the ectopically erupting /impacted canines; the predictability of the treatment options is often determined by various factors including: patient’s age, root formation, tooth position, tooth angulation, proximity to adjacent teeth, etc.

The canines for this particular patient were rather horizontal in angulation and the crowns of the canines were in close proximity to the roots of the central incisors. This presented risk not only to the roots of the lateral incisors but also to the central incisors. We elected to address the canine with surgical exposure of the canines and utilizing orthodontic treatment to guide the impacted teeth into their proper position. The primary canines were extracted, the canines were exposed, and buttons with micro-chains were placed on the impacted teeth. Orthodontic treatment was used to create the space needed for the canine in the maxillary arch and specific orthodontic mechanics were applied to guide the teeth in a distal vector of force – away from the adjacent roots and teeth; this careful approach helps minimize potential root damage as well as other compromises.

Orthodontic treatment by: Dr. Yossi Bar-Zion, DDS, MS

Surgical exposure by: Dr. Jon Nakano, DDS.