Partial maxillary osteotomy following an unsuccessful forced eruption of an impacted maxillary canine: 10 year follow-up. Review and case report

Mário Alexandre Morganti,Henrique Voltollini De Azambuja,Deise Ponzoni,Clarice C Friedrisch,Edela Puricelli

doi:10.1590/s1678-77572012000600013

Abstract

The maxillary canines are amongst the most frequently impacted teeth, second only to the third molars. Several conservative orthodontic and surgical techniques are available to position the teeth properly in the dental arch, even in severe cases. However, when an extraction is necessary, it often leaves a critical alveolar defect of difficult management. The authors present the technique of Partial Maxillary Osteotomy, in which a dento-alveolar segment is moved mesially, hence closing the remaining space, allowing for the formation of healthy periodontium and resulting in an adequate functional and aesthetic outcome. A case report is presented with a 10 year follow-up, proving the technique's stability in the long term.

Highlights

A tooth is considered impacted when it does not erupt within its expected physiological time[17] or if it has not completed erupting until six months after the homologous has been positioned in the dental arch, with a complete radicular formation[14]
The maxillary canine plays a key role in the functional aspects of the bite, taking part of the anterior guidance either on a canine protected occlusion or group function
Those, when located on the apical third of the impacted maxillary canine’s root, close or into the apex of a triangular pyramid formed by the conjunction of the nasal, sinusal and alveolar corticals, called the Ennis inverted Y, oblige the clinician to produce precise diagnostics[17,18]

Summary

Introduction

A tooth is considered impacted when it does not erupt within its expected physiological time[17] or if it has not completed erupting until six months after the homologous has been positioned in the dental arch, with a complete radicular formation[14]. Those, when located on the apical third of the impacted maxillary canine’s root, close or into the apex of a triangular pyramid formed by the conjunction of the nasal, sinusal and alveolar corticals, called the Ennis inverted Y, oblige the clinician to produce precise diagnostics[17,18]. In these situations, intra and extra-oral radiographic examinations are necessary for a suitable evaluation of the affected region, including tridimensional images, generated by cone-beam computed tomography[2,9,16,18]. If severe interference is noted, a pre-surgical orthodontic stage might be necessary

CASE REPORT

Findings

DISCUSSION

CONCLUSIONS