Extrusion of the ectopic maxillary canine using a lower removable appliance

Abstract

The ectopic eruption and impaction of maxillary canines is a frequently encountered problem. The prevalence is estimated to be between 0.92% to 2.2%. It is found to be palatal to the dental arch in about 85% of cases and buccal only in about 15% of cases. Ericson and Kurol suggested that removal of the deciduous canine before the age of 11 years will normalize the position of the ectopically erupting permanent canine in 91% of cases if the canine crown is distal to the midline of the lateral incisor. We strongly endorsed this interceptive approach. Early recognition that a canine is erupting ectopically is extremely important. Ericson and Kurol estimate that in 0.71% of children in the 10 to 13 year age group, permanent incisors have resorbed because of the ectopic eruption of maxillary canines. Resorption may be found as early as 10 years but occurs most frequently in the age groups 11 to 12 years. In this article a simple, well-clasped lower removable appliance is shown to be an excellent base for using light elastics to move the impacted canine, first posteriorly away from the incisor roots and then vertically and buccally. A gold chain is bonded to the unerupted canine to provide a simple and flexible means of traction that ensures the canine erupts into a zone of attached mucosa with normal crown length.