The comments
Dr Sylvain Chamberland, Orthodontiste says:
You may benefit from an orthodontic treatment that could include extraction of maxillary premolar or you may have retrusion of your mandible and you may benefit from orthognathic surgery to advance the mandible. All of this means comprehensive orthodotnic treatment.George says:
Hi doctor,i have deep overbite and my maxilla protrude.. is there any treatment for my case? ThanksLisa says:
I am 27 years old ad have an impacted upper canine. I can send an xray but not sure where. Do you think it is worth replacing the canine with the baby tooth and if not what other options do I have if the baby tooth decides to come off. thank you!HLM says:
I took your advice and after 6 months my overjet increased only 1.8 mm, after another 6 months another 1 mm. It's slowing down and still less than 5 mm (total now a little less than 3.8 mm) so I'm not concerned as its advantages, at this point, far outweighs any disadvantage so far. I now have a VERY tiny space between my right incisor and the tooth next to it.Dr Sylvain Chamberland, Orthodontiste says:
There could be many reason to remove your impacted canine, but there might be some to just follow up each year. I can not tell without an xray.Michele says:
I am age 59 with canine tooth still in the roof of my mouth. The primary is long gone, there is no space for it to move down. Any reason for me to have it removed?Neha says:
Hi doctor, I have my upper lip protruded. The doctor says that i have to get two premolars extracted from the upper jaw is narrower. Lower jaw is fine so no removal of premolars is suggested. Though the doctor has first advised to go for the braces, but I work in entertainment industry and I can't get the braces. So for invisalign, the orthodontic says I have to get my two premolars removed. Will that change my facial aesthetics in any way? Is it the right thing to do? Please help asap.Angie says:
Hi, My 8 & 1/2 year old daughter was referred by her dentist to an ortho because of her upper canines coming in crowded. I took her for 2 ortho consults. One ortho said do a rapid palate extender and front braces to make room for the canines and not damage the roots on the front teeth. The other ortho said to do nothing and wait and see if they come in normally. Do you think they’re in zone 1 or 2 and will come in normaly? Or should we do the RPE? I’ll send the X-ray to your Facebook. Thanks!!Cindy says:
Hello Dr,My name is Cindy. I’m 38 years old. I have bimaxillary protrusion with the midline deviation and crowding in the lower anterior teeth. I got my 1 st premolars extracted except on the right lower where I got my 2 Nd premolars extracted. My orthodontist advised me to go for Invisalign and he showed me the clincheck results too. Can you please provide me your suggestion if Invisalign could work or the traditional metal braces . Thanks in advance.
Jennis says:
Hi, my daughter is 12 yrs and previously she had her upper premolars extracted to pave way for the canines which were stuck in. Then yesterday when she was being extracted the lower premolars to balance the top, one of the canine was extracted by mistake and her dentist advised to remove the other canine to balance instead of the premolars. Now my daughter has upper canines and no lower canines will it have any negative impact on her?Dr Sylvain Chamberland, Orthodontiste says:
If you have dentoalveolar retrusion, you may need mandibular adcancement and genio set back.I disagree totally with chin implant, it will never be esthetic nor bring functionality to the lower lip.
You may have have a short face and a diminish vertical dimension of the face. If so, the best treatment coulb be bimaxillary surgery with clockwise ortation of the occlusal plane.
See Vertical dimension and facial esthetics.
Dr Sylvain Chamberland, Orthodontiste says:
You should initiate orthodontic traction of the impacted canine. I would not wait they erupt by themselves any longer. I am not sure what you mean by implants. I hope it does not mean to remove the canine and replace them by dental implants.At 13 years old, it is not that difficult to bring the canine into occlusion if there is adequate space.
Dr Sylvain Chamberland, Orthodontiste says:
It is sad that your orthodontist did not recognize that the crown of the canine was tipping distally and the root mesially as he tried to open the space for the lateral incisor. You told me it took him 3 years to get to this point.
Like I told you in a separate email, you should get braces to upright the root of the canine distally. This can be done with a box loop that would create a moment to achieve uprighting. You can see on the left side the type of spring that is required.I also told you that removeing the canine or the lateral to place an implant is the worse thing to do. It will never be esthetic.
Moreover, if an implant is planned to replace the lateral, you are still stuck with the root of the canine in the way of the implants.
My best recommendation would be to find an orthodontist who know biomechanics.
Best regards
farah says:
I mean when genioplasty with a chin implant is performed, does the labiomental groove improve? or the implant would accentuate this groove and lower lip would seem retruded?farah says:
Thank you dr.Sylvain for this informative website.-I would like to know what is the best treatment for dentoalveolar retrusion? does the treatment have complications?
-Do you think chin implant is a possible solution cosmetically for lip retrusion?
-Does this problem get worse with aging if not treated?
lots of thanks
Monika says:
Hi Dr. Sylvain. My 13 yr old had laser surgery 1 year ago to expose her palate ectopic canines. One is coming down more than the other and the ortho has discussed pulling them and putting implants in or not having canines altogether. I'm thinking of getting a second opinion as I don't want to give up. You can see them in the palate, but the progress has been slow. Your thoughts?Jasmin says:
Hi Doctor.I have an ectopic canine from the upper left side and had my braces recently but I just remove last 1 month ago.they exchange position from my lateral incisor but the problem when my doctor move to its original position the roots of my canine can't move because of the lateral incisor. When I get second opinion to other orthodontist, and have my 3D xray. Then he see that I am having a bone loss from the canine teeth and should be stop on making a movements so that it will not worsen the situation. Now, his plan A. TO extract my canine and move my lateral incisor to its original position and had my dental implant/ partial denture on my canine after the braces treatment. Plan B. Is to interchange or my canine will be place to the lateral incisor and lateral incisor to canine but he told me that if he will do that there's still possibility that I will lose my canine its because of the bone loss.
and just recently doc, I've notice that I have crack in my canine teeth.
I want to send my panoramic and
3D xray but I dont know how.
I want your opinion in my complicated case Doctor. Thank you
Natasha says:
Hi Dr Sylvain!My teeth are protrusive, with slight overbite (roughly 4mm), my chin looks weak when not smiling, I find it hard to close my mouth on rest and sometimes excess gum shows when smiling. The gummy smile bothers me most. I am unsure however whether the excess gum display upon smiling is to do with me having bimaxillary protrusion or vertical maxillary excess. Would it be wiser to proceed with orthodontic treatment with 4 first premolar extractions (I am unsure whether this will get rid of the gummy smile) or to entertain the idea of getting orthognathic surgery to slightly shift my maxilla upward and eliminate the gummy smile for sure?
(Also I do like my midface volume so I think if I do get extractions I may not go for 50:50 space closure)