We all know the effect of impacted canines can have on adjacent teeth ie: ectopic resorption, asides from adding to the duration of orthodontic treatment, by 6 or 12 months longer. Patients also need to undergo a surgical exposure of the teeth, not to mention the increased anxiety about pain & discomfort in the young teenage patient from this procedure. So I would like to share with you 3 cases of early treatment where the impacted canine improved in position. This is not to say all of my early treatment cases did not require a surgical exposure as a few minority very impacted cases, still needed this. But the point I would like to share with you is an earlier review maximises the options available to these young patients. And often the initial interventions are relatively simple. And yes, we still do offer an obligation free initial orthodontic consultation, so there is no out-of-pocket costs for your young patients.
23 was almost horizontally impacted. She was 9 years old. We extracted the 53 & 63 and made her an upper removable expander which she wore well. The spontaneous improvement in the 23 position was obvious.
After 12 months
This boy was 11 years old when we saw him. At this point, we were concerned about the 13 & 23 positions, so we extracted the upper right and left deciduous canines and made him an upper removable expander. Clear improvements were seen in the 13 & 23 positions after 12 mths. 3 years after phase 1 treatment, his 13 & 23 were now erupting and braces were fitted. No exposure of canine teeth were necessary.
1 year later
3 years later (from initial)
Where the arches are very crowded in the canine region, I would often fit an expander in the upper arch and place upper braces to re-distribute the space gained to the specific canine region. I find this generally works well to promote the spontaneous eruption of the canine, especially when the root apex is still open. I have treated many similar cases like this and in the vast majority, the canine spontaneously erupts.
During expander and braces
On the contrary, where the canine does not erupt, it is often due to prolonged impaction and an older teenager upwards ie: in an older patient where the apex has closed. The 17 year old patient below was a classic example of this. Note the impacted 43.
Progress- 43 had to be surgically exposed as no spontaneous eruption had occurred after we opened space