Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Nov 17;59(11):2032.
doi: 10.3390/medicina59112032.

Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report

Marcin Stasiak  1 , Aleksandra Kołodziejska  2 , Bogna Racka-Pilszak  1
Affiliations
Case Reports

Orthodontic Treatment of Palatally Impacted Canines in Severe Non-Syndromic Oligodontia with the Use of Mini-Implants: A Case Report

Marcin Stasiak et al. Medicina (Kaunas). .

Abstract

Background: The risk of palatally displaced canines (PDCs) rises in patients with tooth agenesis. The orthodontic extrusion and alignment of PDCs require adequate anchorage to enable tooth movement and control the side effects. There is no paper presenting treatment in the case of severe oligodontia with simultaneous PDCs and the use of mini-implants (MIs) for their orthodontic extrusion. Case presentation: A 15-year-old patient presented with non-syndromic oligodontia and bilateral PDCs. Cone beam computed tomography revealed that both PDCs were in proximity to the upper incisors' roots. There was no evident external root resorption of the incisors. The "canines first" approach was chosen. MIs were used both as direct and indirect anchorage. First, the extrusive forces of cantilevers were directed both occlusally and distally. Next, the buccal directions of forces were implemented. Finally, fixed appliances were used. PDCs were extruded, aligned, and torqued. Proper alignment and occlusion were achieved to enable further prosthodontic restorations. Conclusions: The use of MIs made it possible to avoid collateral effects, reduce the risk of complications, and treat the patient effectively. MIs provide adequate anchorage in demanding cases. The use of MIs for the extrusion of PDCs made it possible to offer this treatment option to patients with severe oligodontia. The presented protocol was effective and served to circumvent treatment limitations associated with an inadequate amount of dental anchorage and a high risk of root resorption.

Keywords: cone beam computed tomography; impacted canine; oligodontia; temporary anchorage device; tooth impaction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Initial extraoral photos.
Figure 2
Figure 2
Initial intraoral photos.
Figure 3
Figure 3
Pretreatment panoramic radiograph.
Figure 4
Figure 4
Pretreatment lateral cephalogram.
Figure 5
Figure 5
Cone beam computed tomography cross-sections with palatally impacted maxillary canines. (a) Upper right canine; (b) Proximity of the upper left canine and the upper left central incisor; (c) Upper left canine; (d) Transversal cross-section; (e) Horizontal cross-section; (f) Cone beam computed tomography rendering.
Figure 6
Figure 6
Treatment process. (a) Surgical exposure; (b) Placement of palatal alveolar mini-implants and installation of cantilevers; (c) Orthodontic extrusion with cantilevers in distal and downward direction; (d) Orthodontic extrusion with power chains; (e) Derotation of canines with power chains; (f) Extraction of upper right deciduous canine and buccal movements of impacted canines; (g) Palatal alveolar mini-implants and cantilevers for buccal tooth movements; (h) Buccal alveolar mini-implant and cantilever for buccal movement of upper left canine; (i) Mini-implant in the palatal suture used as direct anchorage for upper left canine and bend-out for upper right canine; (j) Cantilever for buccal movement of upper left canine; (k) Mini-implant in the palatal suture used as indirect anchorage; (l) Intermaxillary elastics from palatal buttons on upper lateral incisors to the lower arch.
Figure 7
Figure 7
Panoramic radiograph performed after orthodontic extrusion.
Figure 8
Figure 8
Panoramic radiograph performed during the finishing phase.
Figure 9
Figure 9
Final extraoral photos.
Figure 10
Figure 10
Final intraoral photos.
Figure 11
Figure 11
Posttreatment panoramic radiograph.
Figure 12
Figure 12
Posttreatment lateral cephalogram.
Figure 13
Figure 13
Superimposition of the initial (black color) and final (red color) cephalometric radiographs to monitor skeletal and soft tissue changes. (a) Superimposition of cranial base structures; (b) Maxillary superimposition; (c) Mandibular superimposition.
Figure 14
Figure 14
Extraoral photos after the initial phase of prosthetic treatment.
Figure 15
Figure 15
Intraoral photos after the initial phase of prosthetic treatment.
Figure 16
Figure 16
Changes in the canines’ anatomy due to conducted orthodontic treatment. (a) Upper right canine; (b) Upper left canine; (c) Bone defect of upper left canine—sagittal cross-section; (d) Bone defect of upper left canine—horizontal cross-section.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Letra A., Chiquet B., Hansen-Kiss E., Menezes S., Hunter E. Nonsyndromic Tooth Agenesis Overview. In: Adam M.P., Everman D.B., Mirzaa G.M., Pagon R.A., Wallace S.E., Bean L.J., Gripp K.W., Amemiya A., editors. GeneReviews®. University of Washington; Seattle, WA, USA: 1993. - PubMed
    1. Bergendal B. Orodental Manifestations in Ectodermal Dysplasia—A Review. Am. J. Med. Genet. A. 2014;164A:2465–2471. doi: 10.1002/ajmg.a.36571. - DOI - PubMed
    1. Tuna E.B., Koruyucu M., Kürklü E., Çifter M., Gençay K., Seymen F., Tüysüz B. Oral and Craniofacial Manifestations of Ellis-van Creveld Syndrome: Case Series. J. Craniomaxillofac. Surg. 2016;44:919–924. doi: 10.1016/j.jcms.2016.04.025. - DOI - PubMed
    1. Tuna E.B., Sulun T., Rosti O., El Abdallah F., Kayserili H., Aktoren O. Craniodentofacial Manifestations in Hallermann-Streiff Syndrome. Cranio. 2009;27:33–38. doi: 10.1179/crn.2009.006. - DOI - PubMed
    1. Ruiz-Heiland G., Lenz S., Bock N., Ruf S. Prevalence of WNT10A Gene Mutations in Non-Syndromic Oligodontia. Clin. Oral Investig. 2019;23:3103–3113. doi: 10.1007/s00784-018-2731-4. - DOI - PubMed

Publication types

LinkOut - more resources