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I think you should consider a comprehensive orthodontic orthognatic surgical treatment. The type of treatment you need CAN NOT be order online.
Your situation need carefull evaluation. One of them, is it feasible to bring your canine into the arch?
Is it deeply impacted? If you can feel it with your tongue, it may not be that deep.
I can't give you a good advice without seeing the panogram and doing a clinical exam.
I found out that I did not answer your question. The answer is Yes, you should remove the primary canine.
Thanks for sending the photo. You have a cross bite of your upper right lateral incisor with the lower right canine. I understand that the radiography that you sent me was flip horizontally. I thought it was your left maxillary canine, but in reality, it is the right maxillary canine.
From the pircture I saw, it seems that the crossbite extend to the 1st and 2nd upper right premolar. If true, how will it be manage?
I agree that the lateral incisors should not be bonded nor engage into the main archwire until the palatally impacted canine is not displaced. Will you have a surgical exposure and orthodontic ligature of the canine?
Dear L,

You need to comprehend that the teeth that shifted toward the missing canine have to be recentered. Therefore you will likely need comprehensive orthodontic treatment. This may include extraction of premolars if there is not enough space.

However, it is possible that you don't need extraction. I can't tell because I don't have enough information.

If you choose to extraction the impacted canine only and get space close, the teeth deviation may only get worse.
Q1- If the midline did not changes, chances are that the overgrowth has stopped.

Q2- To assess with certainty that the growth has stopped, you will need a scintygraphy with Tc-99. I am assuming that you had one when it was noted that your condyle was actively overgrowing. Usually, when a scintigraphy is positive, a new one should be done 6 month to 1 years after to assess if the growth/overgroth situation came back to normal.

Q3- If you don't have any significant TMJ problem beside one condyle being larger than the orther one, there would be no reeason to do a condylectomy. Particularly if the scintigraphy is negative.

Q4- I can't comment on this. I am a clinician. So far, the high condylectomy were that my patient has were safe and unventfull. I know that one patient of a collegue had continued overgrowth during the next following 10 years. It was explained by the fact that the surgeon could not removed all the affected portion of the condyle.
Claudia, yes it will help because I am getting confuse. The flow of answer does not indent orderly and it get me lost to whom am I answering.
There is a possibility that the roots of the incisors already have some damange.

There is a possibility an orthodontic traction of an impacted canine could damage the root of the incisors, but the direction of traction is very important as one should pull the canine away from the roots from start.

I don’t know your age, but I usually try to bring the canine although there are some circumstance I will decide or have to extract the impacted canine.

I apologies for not uploading an exemple. It seems that there is a blocage in the system.
There is no magic. If your gums/ teeth/ lips looks protruded chance are that you need extraction and full comprehensive orthodontic treatment.

If you have excessive showing of gum at rest and on smile, chances are that you have a vertical maxillary excess, hence you need orthognathic surgery and a comprehensive ortho treatment with or without extraction.

That is likely your choice.
There is a possibility that the roots of the incisors already have some damange.

There is a possibility an orthodontic traction of an impacted canine could damage the root of the incisors, but the direction of traction is very important as one should pull the canine away from the roots from start.

I don't know your age, but I usually try to bring the canine although there are some circumstance I will decide or have to extract the impacted canine.

I apologies for not uploading an exemple. It seems that there is a blocage in the system.

 

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