The comments
Gogu says:
Hi Dr Chamberland, you've got some incredible advice here! I'm a 33 yo male with one horizontally impacted canine as seen in the pic. I have been feeling guilty that I chose not to get it pulled down when I got braces when I was 20. Could you please look at it and see if it is actually in a favorable location to have been pulled down? Based on what I've read, it is probably not, because the angle to midline is 60 or more and it is at the top third of the adjacent incisor, possibly risking damage to the latter's root upon pulling. I still have the deciduous canine and I have no symptoms. My ortho said the latter looks strong and may last me a lifetime. What do you think is the best management in this situation? Leave it alone or do something? Thank you.https://photos.app.goo.gl/ndTopLE17LtgRKM57
deepak says:
in which treatment to cure case 2 in this picture doctorDr Sylvain Chamberland, Orthodontiste says:
I agree that the removal of the primary teeth will favor eruption of the permanent canine, but he may still need further intervention.That is a good thing to have a lingual arch to maintain space while checking the evolution of the impacted mandibular canine.
I did not see the severity of the impaction, extraction would be my very last choice. Yes it may mean an implant for the future unless it is possible to extract 3 other teeth (3 first premolar) to achieve the equivalent of 4 dental unit extraction and close all space for camouflage.
You can share the panogram via message to https://www.facebook.com/drsylvainchamberland/
Sum says:
Hi, My son is 11 years and 5 months. He has impacted canines one in lower jaw and other in upper jaw opposite side. The orthodontist first recommended to take out baby teeth to create space for the permanent teeth to erupt normally and the impacted canine may get the space sense to straighten on it’s own. He has already got lingual arch to maintain the space after extraction of baby teeth in lower jaw. However another orthodontist suggested extraction of that impacted canine in lower jaw. We are quite concerned about the two opinions. Will extraction of impacted canine cause danger to the roots of front permanent teeth? And will extraction of impacted canine means confirm implant in future? Is there another way to save the two impacted canines? Please let me know how to share the X-ray.Thank you
Dr Sylvain Chamberland, Orthodontiste says:
I would, by far, recommend option 1: extract 1 upper premolar and the deciduous canine on the other side. I had a canine removed in my early teens and I spent all my life with a 1st premolar on one side and a canine the other side.I would NOT extract a good premolar and then later place an implant to replace the missing tooth.
Lynda says:
Hello, I have a class 2 division 2 malocclusion and a palatially impacted maxillary canine. My ortho said that as I am 34 it would be very difficult to bring down the impacted tooth with orthodontics so I had it removed. He is going to align the teeth and has given me two options to disguise the malocclusion. Option 1: extract one upper pre molar & one deciduous canine (which I still have at 34 years old!) and move all teeth back or Option 2:remove both upper premolars and replace deciduous canine with implant. Any advice you could give me would be gratefully received.Dr Sylvain Chamberland, Orthodontiste says:
It may come by itself but it may take 6 to 12 months. You can send the panogram via my professional facebook page.Dr Sylvain Chamberland, Orthodontiste says:
Mild-moderate crowding, strong chin, deep labiomental angle, both lips behind e-lineCHances are that extraction of 1st premolar in a mild to moderate crowding situation may cause some retraction of the lips, hence increasing the apparence of a strong chin.
Moreover, you said you have a squarish face, this likely mean low mandibular plane angle. You have a deep bite + deep curve of spee. It may be very difficult to open the bite with extractions.
What was the reason to not trye a non extraction approach?
Karla says:
Hello! I just got my braces on three days ago because I have an impacted canine .. my baby canine is going to be extracted next Tuesday and then I hope the permanent canine will come down by itself.. I am 15 years old and I was wondering what you think how long that process might take?Is there a chance I could send you the x ray where you can see my impacted canine?
Kyla says:
Hi.My Situation:
class 2 division 1, mild-moderate crowding on both arch, 5mm overjet, retroclined lower incisors, deep curve of spee, deep bite. both lips behind e-line, strong Chin, acute nasiolabial angle and labiomental angle.
Treatment: 4 first premolar extraction to relieve crowding. Space closure by moving upper incisors into extraction space and lower posterior teeth forward.
Upper lip should move in abit and improve the nasiolabial angle, and lower lip should not move in.
My concern is that I’m a few months into alignment, and the lower incisors seems to be retroclining more, and curve of spee getting deeper. I’m concerned about dished in lower lips.
I’m 20 years old and I suppose I’m non-growing? So Was wondering about the effects of class 2 elastics on people of my age group with regards to my aforementioned concern. would the elastic be able to move the lower incisors out and the lower lips out abit, improve lip support and increase labiomental angle? Or does it only work to bring the upper teeth in?
Also i have a square-ish face, and I heard class 2 elastics could cause backward jaw rotation/increase angle of mandible/increase anterior face height and decrease ramps height, and make the face more v-shaped? But is these only in growing patients?
Thank you!
ABS says:
Many diseases of the oral cavity can't be seen when the dentist examines your mouth. Dental x-rays are images that can help the dentist see things the human eye can't detect, such as tiny areas of decay between the teeth and the position of unerupted teeth in children and adults.Dr Sylvain Chamberland, Orthodontiste says:
Il faaut déterminer l’état de votre condyle gauche, mais il est vraisemblable qu’une chirurgie orthognathique soit le meilleur traitement pour votre cas.Dr Sylvain Chamberland, Orthodontiste says:
The way I understand the description of your malocclusion, you will likely benefit from extraction of premolars, reduction of the dentoalveolar protrusion and orthognatic surgery that would include Le Fort 1 for superior repositionning of the maxilla, BSSO, and a genioplasty.I recommend 100% space closure.
Dr Sylvain Chamberland, Orthodontiste says:
I would like to know if it was an oral surgeon who tried the extraction. It is very unusual.Dr Sylvain Chamberland, Orthodontiste says:
I would wait to get the 1st molar in. i would not rely on deciduous molar that are necrotic and mobile. But yes i did PFM in youger patient on their deciduous second molar.I hope that help
Dian Amir says:
Hi Dr. ChamberlandMy patient is a boy 8 yrs old, with maxillary retrognathi, crossbite anterior teeth and posterior teeth. His permanent first molar is not full erupted yet and dm2 has necrotic and mobile also. I'm planning to use PFM.
What is your suggestion about type of RME and hook for PFM for this case? Should I wait until the maxillary permanent molar full erupt, so I can put the molar band on it.
I'm looking forward hearing from you
Thank you Doctor.
Monika Meher says:
I've permanent canine teeth inside my upper jaw. Doctors said they have to be removed because of which I got a gap.between my two incisors. Today I went to the hospital and doctor tried to remove the tooth but he couldn't as they are difficult to extract.. he somehow extracted two pieces of one canine but not completely. The procedure was so painful. Now I don't want to continue with that. I just want to kmow that whether me of nor continuing with the further surgery make any complications?Dr Sylvain Chamberland, Orthodontiste says:
The retained primary canine will not survive to cerammic crown. You will loose both the canine and your money.Your case is very comlex and is not fitted for Aligner therapy.
The best treatment you can have is full comprenhensive treatment with braces and traction of the impacted canine.
You can send photo via my professional FB page.
Jacqueline says:
Hi Dr. Chamberland!I am a 23 year old with a platally impacted canine. I still have the retained primary canine. The retained primary tooth has slowly began to decay over the past 5 years and it now has a noticeable cavity that has formed on the side of the tooth that meets the neighboring molar. It is not causing me any pain or discomfort the only complications are the embarassing aesthetics of it (noticeable black spot and size). My other issue is the upper canine on the adjacent side DID erupt as a child but it is causing me to have a severe cross bite and unpleasant smile since it is basically "caved inward" towards the roof of the mouth which causes it to rest behind my lower canine when I bite. And lastly, my two upper front teeth seemed to have suddenly shifted tightly together causing me pain and pressure and making it hard to floss. So My questions are
Since I can't afford the typical surgery it would take to correct my issues can I start by correcting my cross bite with invisalign? And then have a crown placed on the retained primary canine to meet aesthetics? And what could be causing this sudden tight shift in my front two teeth, could it have anything to do with the impacted canine or possibly root resorption? Thank you for any advice you can offer me! I can also send you photos if needed.