Two patients with severely displaced maxillary canines respond differently to treatment.

Abstract

The patient with a severely displaced maxillary canine continues to challenge the orthodontic specialist. When the two patients in the following case reports presented, their problems seemed similar: each had a palatally displaced canine. However, unique clinical problems were soon diagnosed that led to the development of different treatment approaches. These differences are worth discussing, especially in light of newly published studies. In planning treatment for these two patients, the following questions are worth considering. 1. Is it common for other dental anomalies (small lateral incisors, missing teeth) to occur more frequently in patients with palatally displaced canines? 2. Following surgical exposure of palatally displaced maxillary canines, how significant are the risks of tooth movement with regard to periodontal health, vitality, and retention? 3. Are new or improved surgical procedures becoming available to bring severely impacted teeth into alignment? 4. When planning ahead to replace a missing premolar with an endosseous implant, is it better to retain the primary molar as long as possible or extract it during treatment? 5. How stable is the closure of a maxillary median diastema years after a reasonable period of retention?