Abstract
The impaction of permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. This case report describes a new orthodontic-surgical approach through the use of CO2 laser, for the exposure of the palatally impacted canines. A 13-year-old female referred to our observation to make an orthodontic examination because of the maxillary primary canines’ persistence in upper arch. Orthopanoramic X-ray showed impaction of both permanent maxillary canines. The family history revealed that the patient’s mother had the same orthodontic problem. Cone Beam Computer Tomography (CBCT) was requested to plan the surgical-orthodontic treatment. Surgical exposure of the impacted canines was performed using a CO2 laser and subsequent periodontal pack application. No orthodontic devices were applied for impacted teeth traction on dental arch. Canines’ movement was monitored at 1, 8 and 16 weeks post-surgery with photo and intraoral scanner CS3500 (CS3500®, Carestream Health, Atlanta, GA, USA). When canine crowns were completely erupted on palatal side, the alignment in the arch with indirect bonding technique was performed. Complete disimpaction of canine crowns was obtained in only four months. As reported in the literature, this case confirms that impacted canines’ exposure to CO2 laser has advantages if compared with traditional surgery: no bleeding during and after the procedure, decontaminant effect on the surgical area, no suture, and a fast spontaneous eruption. Conclusions: The pre-orthodontic uncovering and autonomous eruption of palatally impacted maxillary canines provides simplified, predictable, and more aesthetic outcomes. Furthermore, a significant positive factor is that there is no need to carry out the orthodontic traction of the impacted element, undoubtedly better compliance by the patient during the next alignment phase with the fix orthodontic appliance.
Highlights
The impaction of a permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment
The cause of impacted maxillary canines is not exactly known; it is commonly thought that palatally impacted canines are associated with hypoplastic or missing lateral incisors (“the guidance theory”) or with aplasia of premolars and third molars and supernumerary teeth (“the genetic theory”)
From other studies [18,19,20], it emerges that low-energy lasers can stimulate the proliferation of osteoclasts, osteoblasts, and fibroblasts, and thereby affect bone remodeling and accelerate tooth movement
Summary
The impaction of a permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. The cause of impacted maxillary canines is not exactly known; it is commonly thought that palatally impacted canines are associated with hypoplastic or missing lateral incisors (“the guidance theory”) or with aplasia of premolars and third molars and supernumerary teeth (“the genetic theory”). J. 2021, 9, 66 is not exactly known; it is commonly thought that palatally impacted canines are associ of 8 ated with hypoplastic or missing lateral incisors (“the guidance theory”) or with aplasia of premolars and third molars and supernumerary teeth (“the genetic theory”). The early diagnosis of canine displacement in relation to the surrounding structures is based primarily on radiographic examination.
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