The comments

Zar Haider says:

Hi
I am a dental student. wanted to ask can we have a class ll div2 with a class l molar occlusion on one side and 0.75 class ll molar relation on the other side.
many thanks

Dr Sylvain Chamberland, Orthodontiste says:

Chances are that her canine is impacted and the at primary canine is retained. She may need surgical exposure and orthodontic traction.

Dr Sylvain Chamberland, Orthodontiste says:

I would recommend you Dr Larry Wolford

Dr Sylvain Chamberland, Orthodontiste says:

The cause of root resorptionin such case is the canine that is damaging the root as it erupt. It is a well known and accepted fact that once the canine is moved away from the root, the resorption stops. External root resorption is a very different problem than internal root resorption where the cause of the resorption come from the pulp.

I hope that help.

samane says:

hi,would you please give me some evidence about leaving the root to heal by themselves instead of doing RCT ?? I'm an endodontist and i'm searching fore evidences in this field,but unfortunately i don't have access to any of the studies in this field

Julie says:

Where can I find a list of top surgeons in the world who specifically trained in ICR corrective surgery? I'm willing to travel almost any where to get the best surgeon.

Veena Suresh says:

My daughters first tooth came only when she was 2 1/2 years old. Now she is 14 and her right canine has not come yet. She had the habit of thumb sucking and so the front teeth are very much protruded out. We showed the case to many doctors so that she could get braces.All the doctors are of the opinion that braces could be put only after the canine is out. Is there a chance that her canine might be impacted.Appreciate your opinion.

Thanks

Dr Sylvain Chamberland, Orthodontiste says:

You can send your photo and CT scan to my professional facebook account: facebook.com/drsylvainchamberland. If you do so, it means that you authorize me to publish it. Of course I will hide your identity and block your eyes to make sure your anonymat is preserved.

I will change your identification and use only your 1st name.

Arghavan says:

My name is Arghavan and I am a general physician in I.R.Iran.
I have had the same problem that this little girl has, I had a neglected condylar fx when I was 1 year old ,
The diagnosis was confirmed 2 year later when my parents began to notice the asymmetry in my face.
The doctor said I should wait until I'm 21 so I did.
2 years ago when l was 25 I finally got a correction surgery which unfortunately did so little for my problem. If you are interested I can email you my profile and my CT scan before and after the surgery. I hope to find a way so my face can become fully symmetric because it has impacted my self esteem a great deal.
Regards

Dr Sylvain Chamberland, Orthodontiste says:

Your queston is too vague. You probably mean that you have a class II malocclusion with deep bite and protruded upper jaw, but there is so many way to address such malocclusion, it is impossible to receommend a treatment without a clinical exam and xrays.
You should consult an orthodontist.

Dr Sylvain Chamberland, Orthodontiste says:

Fast Braces is the new name of a bracket systems that was a comercial failes somes 20 years ago. In that time, it was called Viazis braces.

I can't explain qhy the aligment of your teeth are worsening. May be you should get a 2^nd opinion.

Fast braces DOES NOT mean "better."

Dr Sylvain Chamberland, Orthodontiste says:

I would do extraction of the primary canine first, put braces soon after align the teeth and reassess 6 month later for the position of the canine. If it improve, one may decide to wait another 6 months or to do a surgery to epxose and attach it.

Dr Sylvain Chamberland, Orthodontiste says:

I apologies for the delay in responding.

There are several aspect with your questions.

I would not keep the canine for a long period of time if no one attemps orthodontic traction, but you can monitor it every year.

SHe has an open bite and at 11, she is still growing. It  may be a wise idea to monitor her groth for 2 -3 years. Any orthodontic treatment to close the open bite is prone to relapse because she is growing.

If extraction is done, do not worry about bone loss. It will fill in. Except at the site of the primary canine.

Sorry, I have to go. I hope I was of some help.

Best regards

 

Dr Sylvain Chamberland, Orthodontiste says:

Interceptive extraction of deciduous canine on palatally displaced maxillary canines

Bonjour Neha K and thank you for sending me the panogram.The best interceptive approach is to extract both deciduous maxillary canines (both marked X) and reassess in 6 months with a new panogram then 6 more months.

I agree that rapid maxillary expansion can help. I often do both. I mean expansion and extraction of the primary canines.Chances are that I would do it for you child.

However, it is useless at this stage to put braces on the central incisors unless there is a significant esthetic and social issues caused by dental spacing. You have plenty of time ahead to do braces that will be unavoidable anyway.

Regarding the prognosis of UR3 (#23 in FDI, #11 in your system), it may need to be expose and need an orthodontic traction. But you have plenty of time ahead to see what happen with interceptive procedure.

For sure she will need phase 2 comprehensive orthodontic treatment, but let her grow in the meantime (after exo of Cs and RME).

It might be to early to decide if we plan a dental impant at 18 or substitution of the missing teeth. Both option might be good.

I hope that help.

Bazargani F, Magnuson A, Lennartsson B. Effect of interceptive extraction of deciduous canine on palatally displaced maxillary canine: a prospective randomized controlled study. Angle Orthod. 2014 Jan;84(1):3-10. doi: 10.2319/031013-205.1. Epub 2013 Jun 18.

Baccetti T, Sigler LM, McNamara JA Jr.  An RCT on treatment of palatally displaced canines with RME and/or a transpalatal arch. Eur J Orthod. 2011 Dec;33(6):601-7. doi: 10.1093/ejo/cjq139. Epub 2010 Nov 8.

Armi P¹, Cozza P, Baccetti T. Effect of RME and headgear treatment on the eruption of palatally displaced canines: a randomized clinical study. Angle Orthod. 2011 May;81(3):370-4. doi: 10.2319/062210-339.1. Epub 2011 Feb 7.

Neha K says:

I want to get your opinion on a very complex case of my 9 yrd old kid. I have got two mixed consolations from local Orthodontists. Since my kid’s case is very complex wondering if I can share her panoramic xray with you and get your opinion.
Findings:
A. She has midline discrepancy on the top
B. Narrow dental arches(top)
C. Impacted first molars #3,#14and slow eruption
D. Impacted Canines #6,#11 one is at an angle and other is close to nasal area sitting horizontally
E. Missing permanent lateral incisor #7
F. Slight open bite
G. Crowded teeth

Julie says:

Our 15 year old son's #6 upper right canine is impacted. The orthodontist has recommended braces for a couple months before having the primary canine removed while exposing and bracketing the permanent canine for pulling it down. In reading your article, which notes the evaluation by Erikson and Kurol, my son's canine does not exceed 55% and it appears to be within zone 1-2.
Before having the above procedure done, would it be impractical to first consider having the primary canine removed and allowing time for the permanent canine to go back to a normal path of eruption?
(I do have a panoramic xray, but was unsure how to attach).

Rebecca Dunbar says:

Hello Dr.
we will be going back on December 8 to see what they have to say they would like to do with this impacted cainine and get further X-rays and what not.
my husband and I are grateful for time you have spent on this and giving us some direction on what has happened in this case!
Our question is when we take a look with a 3 D X-ray to see where this tooth is lying in respect to the roots of her front teeth..:.if it is not in the roots what do you think about leaving it alone for now?
Watching it to see if it remains stable and do nothing with it....
what is the likelihood that it would continue to travel....is there a good chance that it will surface through the gums into the linguial gum line on its own eventually?
Here is the thing... she has had dental work... she is not the most comfortable in the chair... she has had braces...
she has to have them again because the open bite is opening back up as the orthodontist said it would which really effects her ability to bite through food but we are all fearful of having to put her through surgery now as well and she doesn’t want to have to do it....
not to mention we are concerned for the possibility of something not being best case senerio.
We worry about bone loss in an extraction case would the bone come back when they dig in there to pull it we also worry about possible nerve damage this is her face you know! We are parents so we do worry about what if everything doesn’t go perfect!

Thank you Rebecca Dunbar

tasneem says:

Thank you for your response.
My lower arch does permit. I am consulting with an orthodontist. I am on fast braces for almost a year and my teeth are worsening.
I just don't understand why my orthodontist says he can't move my canine as it will solve the problem.
I'm stressed as a small crooked canine straightened forward. He is straightening so my teeth r coming forward. I'm very unhappy.
My next visit is in 2 weeks. He booked a 45 minutes appointment. He says not to worry but I can c no improvement.
What do I do I have already made full payment.

Dr Sylvain Chamberland, Orthodontiste says:

Sorry for the delay. I am catching up for old comments and question. Your questions came when I was in vacations and it went burried under the pile.
The prognosis of bringing an impacted canine on a 12 years old boy is usually very good.
If you still need an opinion, you can post to facebook.com/drsylvainchamberland

Dr Sylvain Chamberland, Orthodontiste says:

I don't recall that you sent the panogram, but it may take 12 months, may be more to bring high impacted canine.