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Michele M. Figliuzzi, Maria Altilia, Laura Mannarino, Amerigo Giudice, Leonzio Fortunato
Minimally invasive surgical management of impacted maxillary canines
AIM: Combined surgical-orthodontic treatment of impacted maxillary canines has developed significantly in the last few
years, regarding management of both hard and soft tissues and forces of traction. The aim of this report is to describe
a combined surgical-orthodontic approach used to treat an impacted maxillary canine and to value the functional and
esthetic results after 5 years of followup.
MATERIALS AND METHODS: A 13-year-old boy had been seen by surgeons in the Operative Unit of Orthodontics of
Policlinico Tor Vergata in Rome. Radiographic images showed intraosseous impaction of teeth 1.3 and 2.3 in a late
mixed dentition, and the patient was scheduled for the combined surgical-orthodontic treatment.
RESULTS: After the five-year follow-up, the patient had a good occlusal stability. The maxillary canine that had been
orthodontically repositioned showed an adequate width of attached gingiva, which was well keratinized, and the margin
of free gingiva that followed the course of the cement-enamel junction. Bleeding was absent on probing, the periodontal
pocket depth was < 4 mm, and there was no radiographically evident bone loss. CONCLUSIONS: The combined surgical-orthodontic technique used in this case (closed eruption towards the center of the alveolar ridge associated with conservative periodontal surgery, the adhesive technique, and controlled orthodontic traction) simulates physiological tooth eruption and results in proper alignment with good periodontal results. It should be considered as the treatment of choice for impacted teeth whose eruption is not precluded by the position of the tooth and/or the presence of ankyloses.