Lecture Description
Maxillary canine is one of the most frequently impacted teeth after third molar. Tooth-size/arch-size discrepancy (lack of space) is a common etiologic factor of impacted canines and maxillary transverse deficiency is considered to be related with it. To retract the impacted canine successfully, we should make space for the canine and apply appropriate retracting force vector. I think miniscrew assisted-Haas type RPE and cervical pull headgear are good option for making space in mixed dentition, because these appliances can act well without interruption. After making space, surgical opening (full flap closure) and button bonding is done. If the position of impacted canine is severely distal or mesial compared with expected normal canine position, anteroposterior correction of the impacted canine should be preceded for preventing colliding among impacted canine crown and neighboring teeth root during vertical traction. Simple 0.7mm SS wire extension from RPE can attain this correction. After correcting anteroposterior position of impacted canine, guiding wire for canine retraction made by 0.7mm SS wire is attached to the RPE by flowable resin and vertical traction force generated by elastic thread is applied from RPE to the canine through guiding wire hole. Ligature wire extension from the impacted canine is passed through the primary canine root socket for mimicking natural tooth eruption during vertical traction procedure. Elastic thread was changed 4 weeks interval and ligature wire extension from impacted canine was shortened properly. About 9 months later, deeply impacted canine can be retracted successfully, without any side effect such as anchorage problem, occlusal plane canting and periodontal health problem. I will present typical 3 impacted maxillary canine cases treated by these concept and appliances and one impacted maxillary canine case treated by traditional method.