Benefits of Using CBCT in Bilateral Maxillary Impacted Canines Extraction: A Case Report

Aysegul Senemtasi,Neslihan Şenel,Gurkan Unsal,Ilknur Ozcan,Meltem Koray

doi:10.4236/ojst.2019.96015

Abstract

Aim: Canines are the second most impacted teeth in jaws after third molars. Perforation of the anatomic structures, such as maxillary sinus and nasal fossa, are some of the complications of the surgery. In this case, bilateral maxillary impacted canines’ extraction, with the guidance of CBCT is done without any complication. Case: A 24-year-old female patient was referred to Istanbul University, Oral and Maxillofacial Surgery. Left and right deciduous canines and swelling at the right maxillary canine’s labial area were seen during the intraoral examination. Bilateral impacted canines were determined after evaluating the present CBCT images of the patient and orthodontic treatment was advised to the patient. Due to the refusal of orthodontic treament, extractions of the impacted teeth were decided. After the evaluation of CBCT images, the maxillary right canine was determined at the labial site while the maxillary left canine was determined at the palatinale site. Results: Right maxillary canine was lying between the right first incisor and right first molar and It was extracted with mucoperiosteal vestibule flap procedure. For the extraction, the tooth was divided into two pieces from the enamel-cement junction. Left maxillary canine was lying between the left first incisor and left first molar and It was extracted with mucoperiosteal palatinale flap procedure. Flap was stitched primarly with 3/0 silk sutures. Palatinal plaque, which was prepared before the surgery, was applied. Antibiotic, analgesic and moutwash were prescribed to the patient. 1 week following the surgery, stitches were removed and the healing was optimal. Conclusion: Impacted canines are a common clinic condition which requires a multi-discipliner approach. CBCT can increase the success of the treatment by preventing possible complications with determining the proximity of the anatomical structures and the localization of the impacted teeth. There were no sign of complication and the healing was optimal.

Highlights

Maxillary canines, after the third molars, are the most commonly impacted teeth [1]
Bilateral maxillary impacted canines’ extraction, with the guidance of cone-beam computed tomography (CBCT) is done without any complication
Bilateral impacted canines were determined after evaluating the present CBCT images of the patient and orthodontic treatment was advised to the patient

Summary

Introduction

After the third molars, are the most commonly impacted teeth [1]. In general, the causes for retarded eruption of teeth may be either generalized or localized. Surgical manipulation of these bundles can lead to hemorrhage and nerve deficits such as paresthesia, anesthesia, and pain [8] [10] [11] [12] [13] In this case, the importance of CBCT guidance in bilateral maxillary impacte canines’ extraction is reported. Bilateral impacted canines were determined after evaluating the pre-taken CBCT images of the patient (Figure 3) and orthodontic treatment was advised to the patient. Impacted right maxillary canine, which was lying between the right first incisor and right first molar was extracted with mucoperiosteal vestibule flap procedure under local anesthesia. Impacted left maxillary canine, which was lying between the left first incisor and left first molar, was extracted with mucoperiosteal palatinal flap procedure under local anesthesia. The patient is being followed for 2 years without any clinical sypmtoms and complications

Discussion

Findings

Conclusion