Case Report| Volume 3, ISSUE 2, e81-e90, June 2014

Diagnosis, sequencing, and management of bilateral horizontally positioned, palatally impacted maxillary canines with closed surgical exposure and immediate continuous light orthodontic traction


      The diagnosis, sequencing, and management of bilateral horizontally positioned, palatally impacted maxillary canines with closed surgical exposure are presented. An adult female patient presented with bilateral horizontal impactions of the canines, which were situated below the floor of the nose. The sequence and timing of the movements from the initial diagnosis of horizontal canine position are documented, along with the corresponding durations of the horizontal, vertical, and labial movements. Photographic and radiographic timeline documentation is presented, and the stages of movements are displayed, with the corresponding mechanics taking place to produce an ideal occlusion. The patient was treated to an ideal Class I occlusion with ideal facial results, without premolar extractions.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the World Federation of Orthodontists
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ericson S.
        • Kurol J.
        Early treatment of palatally erupting maxillary canines by extraction of the primary canines.
        Eur J Orthod. 1988; 10: 283-295
        • Michell L.
        An introduction to orthodontics.
        3rd ed. Oxford University Press, New York2007: 147-156
        • Jacoby H.
        The etiology of maxillary canine impactions.
        Am J Orthod Dentofacial Orthop. 1983; 84: 125-132
        • Hurme V.
        Range of normalcy in eruption of permanent teeth.
        J Dent Child. 1949; 16: 11-15
        • Wheeler R.C.
        An atlas of tooth form.
        WB Saunders, Philadelphia1963: 38
        • Arvystas M.
        Orthodontic management of agenesis and other complexities.
        Martin Dunitz Ltd., New York2003: 205-218
        • Becker A.
        • Chaushu S.
        Dental age in maxillary canine ectopia.
        Am J Orthod Dentofacial Orthop. 2000; 117: 657-662
        • Bjork A.
        • Helm S.
        Prediction of the age of maximum pubertal growth in body height.
        Angle Orthod. 1967; 37: 134-143
        • Hagg U.
        • Taranger J.
        Maturation indicators and the pubertal growth spurt.
        Am J Orthod. 1982; 82: 299-309
        • Baccetti T.
        • Franchi L.
        • DeLisa S.
        • Giuntini V.
        Eruption of the maxillary canines in relation to skeletal maturity.
        Am J Orthod Dentofacial Orthop. 2008; 133: 748-751
        • Mandall N.
        Radiographic factors affecting the management of impacted upper permanent canines.
        J Orthod. 2000; 27: 169-173
        • Kim Y.
        • Hong H.
        Interrelationship between the position of impacted maxillary canines and the morphology of the maxilla.
        Am J Orthod Dentofacial Orthop. 2012; 28: 556-561
        • Yan B.
        • Fields H.
        Etiologic factors for buccal and palatal maxillary canine impaction: a perspective based on cone-beam computed tomography analyses.
        Am J Orthod Dentofacial Orthop. 2013; 143: 527-534