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Treatment modalities of palatal impacted canines

Abstract

Introduction: The orthodontic treatment of impacted maxillary canine remains a challenge to today’s clinicians. The treatment of this clinical entity usually involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The impacted palatal canine requires a combination of both treatment modalities: orthodontic management and oral surgical treatment. Two types of approach are commonly used: simple exposure, or exposure with bracketing at the time of oral surgery procedure. Bracketing is a well-established and effective method of managing the impacted canine though it has been criticized for increasing the operating time and being a more technique-sensitive procedure.Aim: The aim was to compare the outcome and complication rate for each type of procedure.Material and method: In this study 20 treated patients with both palatal impacted canines were included, one at which the ectopic tooth was surgically exposed alone and the other where an orthodontic bracket was bonded to facilitate early traction, and the flap replaced.Results: In 30 per cent of all cases exposed and bracketed a second surgical intervention was required, compared with 15 per cent in the simple exposure group.Conclusion: Bracketing, though effective, is a more costly and time-consuming procedure, and it is suggested that simple exposure provides an equally efficient and predictable method of managing the palatal impacted canine with obvious clinical and financial benefits

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