Main Instructor 高嘉澤
Department / Institution Chung Shan Medical University Hospital
Classification Case report
「Case」This 20 years old male whose chief complaint was uneruped canine and can`t bite well especially anterior teeth. After clinical examination, patient showed facial slight asymmetry, straight profile and right impacted maxillary canine. Cephalometric analysis showed SNA=85 ,SNB=79 ,U1-Pp=131.5,IMPA=103,ODI=91,The diagnosis was Angle class II malocclusion, with maxillary right impacted canine. Due to high impacted canine ,the treatment plan was to extract impacted canine and closed the space with premolar. The final treatment result was acceptable with harmonious profile and occlusion.
To achieve good functional occlusion, it is crucial to control the rotation, extraction ,and torque of maxillary first premolar. Lateral and protrusive movement without interferance is an another concerning key factors. By the buccal cusp of premolar, and function as canine guidance, the premolar substitution can also be a satisfactory treatment option.
To approach esthetic results, maxillary first premolar`s gingiva margin should be less than 1-2mm of those of central incisors. In some situations, gingivectomy or flap surgery is indicated. In relation to the shape and size, premolars should be recontoured and reduced to coordinate with the width of upper anterior teeth. Additionally, the long-term consideration of periodontal health should be monitored due to the increasing stress placed on first premolars.
In present canine extraction case, the patient treated with canine space closure. Plane the outcome show the premolar substation may achieve an acceptable good function and well esthetic results.
Case Report: The Impacted Canine Management