Lower canine traction with jaw functional orthopedics. case report

Abstract

The treatment of impacted teeth requires an interdisciplinary approach, in which early diagnosis avoids later complications. The frequency of canine retention, especially of the lower canines, has a 0.22 % average in the general population. Case information: A 9.1-year-old patient presented Lepto/Lepto, Lepto; distocclusion due to retrognathism and maxillary protrusion with left condylar asymmetry and preferential chewing on the right side. The patient also presented a structural open bite (Lower Go 78°) hyper-divergence level 4; severe crowding with complete lack of space for tooth 33, and alteration of the eruption corridor of tooth 43. Objective: Stimulate jaw growth to correct distocclusion, stimulate transversal development to gain space and eliminate crowding, and exercise traction on the lower right canine to position it correctly and correct asymmetry. Methods: A series of functional orthopedics devices were used. A Standard Bimler during the first 6 months, subsequently, Simões Network 1 (SN1) to conquer space and initiate traction, followed by the use of an SN11 to correct asymmetry with contra attachment for de-rotation and a lingual S spring. Results: It was possible to obtain incisive contact and align the anteroinferior segment, full space was obtained for tooth 33. Traction of tooth 43 was achieved and thus asymmetry was controlled. Conclusions: Functional orthopedic techniques are an effective form of dental traction that favors treatment from different perspectives. On one hand, it allows to gain space to eliminate crowding. On the other hand, it does not affect neighboring or antagonist teeth because the anchorage is not on the teeth, and it is not necessary to place intraosseous mini-implants. Also, an adequate surgical and functional orthopedic procedure makes it possible to traction the impacted teeth, orienting them to erupt and occupy the correct position in the dental arch.