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Odontomas: obstacle to the eruption of a permanent canine

Question

Dear doctor Chamberland,
I saw your article on the mechanotherapy of impacted canines, I really liked it, but my problem is a little more complicated, and I’m afraid to lose my canine that I have never seen.
I had two odontomas removed which were an obstacle to the canine, and I waited 6 months for the canine to appear but nothing happened, it was very frustrating and according to my orthodontist, my canine is impacted and rotated at the same time.
The only question that I have is: is there a chance that the impacted and rotated canine could appear? I attached two pictures of my panoramic X-ray (which contain dates) and I hope that you, doctor Chamberland, will be able to answer this question and give me advice.
Please, I’m waiting for your response.
Sincerely,

Ben

Presence of 2 odontomas (white arrows) having prevented the eruption of the permanent canine-Dr Chamberland orthodontist in Quebec City

Answer

Mister,

Thank you for providing me with a nice example of odontoma which was an obstacle to the eruption of a permanent canine. I have numerous cases of odontoma in the lower canines or upper incisors. I do not believe having seen one in the upper canines. Thank you, I add your case to my collection.

I would like to answer your question: are there chances that your impacted canine will appear in the mouth?

The answer is YES. But you will have to be patient, because it can take 24 to 48 months without any orthodontic treatment. I guess that you are an adult (> 20 years). The tooth will move and go down. This will take time.

Will the tooth be rotated when it will appear in the mouth. Answer: Yes.

Solution

You can speed up the eruption of this tooth by an orthodontic traction of the canine. We then need to proceed with a surgery to expose the canine and bond a traction wire to it. A removable appliance will be very efficient. However, fixed appliances will be necessary to de-rotate the tooth. The necessary force system is relatively complex.

Good luck

 



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