Early Detection and Interceptive Orthodontic Treatment of Impacted Canine: A Case Report

Abstract

Aim and background: Upper canines are the second most common teeth involved in impaction after the third mandibular molar. Accurate diagnosis at an appropriate age is important to reduce complications of the impacted tooth and its adjacent teeth. We present a case of early detection of an impacted left maxillary canine, which allowed spontaneous eruption through arch expansion.

Case description: An 11-year-old patient was referred for monitoring of an unerupted left maxillary canine. The tooth was palpable labially, but there was a lack of space for an eruption for the tooth, with 2 mm of discrepancy as assessed using the Tanaka and Johnston space analysis method. The patient had generalized gingivitis, multiple carious teeth, and dens evaginatus of upper incisors. An orthopantomogram (OPG) confirmed the clinical findings and impaction of the tooth. Localization of the tooth was done using the parallax technique with the addition of an intraoral periapical radiograph (IOPA). The tooth was in line with the arch. Due to this favorable position, an upper removable appliance (URA) with an acrylic plate, metal clasps on the upper first molars and premolars, and an expansion screw in the midline was constructed for the patient. The patient activated the screw with a weekly quarter turn. Preventive and caries management strategies were done simultaneously. The impacted left maxillary canine erupted after 10 months of using the URA.

Conclusion: Due to the high plasticity of bone structures in a growing child, interceptive orthodontic treatment using removable appliances works well. The impacted left maxillary canine erupted in place after 10 months of using the URA without the need for surgical or fixed orthodontic treatment.

Clinical significance: Early detection of impacted teeth in a growing child is important in order for us to intervene in the problem at an earlier stage to avoid further complications.

How to cite this article: Sockanathan L, Ahmad NS, Zakaria ASI. Early Detection and Interceptive Orthodontic Treatment of Impacted Canine: A Case Report. Int J Clin Pediatr Dent 2024;17(6):706-711.

Keywords: Case report; Impacted canine; Interceptive orthodontic treatment; Removable appliance.