Impacted Canine Exposure and Bracketing Case

This was a nice case that was done by Dr. Biggerstaff and involved a deeply impacted permanent canine tooth.  The patient was referred for exposure and bracketing of an impacted canine – tooth #11 (permanent left maxillary canine) – by her orthodontist when she was 13 years old.  The canine was very high in the upper jaw, and without intervention, would not have been able to erupt into the mouth and become functional.  The patient also had a retained tooth #H (primary left maxillary canine).  Once the braces were placed by the orthodontist, the surgery was then scheduled.  Her surgery involved removing the retained primary canine, exposing the permanent canine, and attaching a gold bracket and chain to the permanent canine so that it could slowly, over months, be pulled into the dental arch in order to become functional.  Usually the gold chain is attached to the arch wire of the patient’s braces about 1-2 weeks following their surgery.  Images #1, 2, and 3 show the preoperative and final radiographs.  One can see that the permanent canine was very high in the jaw bone, almost to the level of the nose.  Image #4 shows the patient at the conclusion of her orthodontic course after her braces have been removed.