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Cephalometric values and panoramic radiograph at the start of treatment.
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The cephalometric evaluation highlighted a brachyfacial typology with a sagittal skeletal relationship of Class I (Figure 2). The panoramic radiograph showed the germs of wisdom teeth of both dental arches (Figure 2).
CT scan showing the axial (a) and the sagittal ((b), (c)) view of the maxillary impacted canine and the axial and frontal view of the mandibular canine ((d), (e), (f)).
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A palatal impaction of the maxillary right canine, the ectopic eruption of the maxillary left canine, and the impaction of the mandibular left canine due to a small odontoma were visible in the CT scan (Figure 3).
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A cantilever modelled using .019'' x .025'' TMA. Initially, a first order:offset (a) and a second order (b) bends are modelled close to the maxillary molar to avoid interferences with premolar brackets and to activate the cantilever. Then, a first order bend (c) directed palatally is used to anchor the canine.
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fig4
TMA wire (Ormco, Orange, CA, USA, Figure 4). TMA is an elastic titanium molybdenum alloy showing Young's modulus of about 100 GPa.
Cantilever activated for obtaining extrusion by a third order bend (a) and a second order bend (b). Cantilevers in position (c).
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fig5
The extrusion of the maxillary right canine was obtained by inserting a third order bend (read as a buccal root torque of the molar) at the insertion of the maxillary molar (Figures 5(a) and 5(c)). For the maxillary left canine the cantilever was activated in extrusion by a second order bend (Figures 5(b) and 5(c)), which determined a caudal displacement of the hook. A second order bend was modelled close to the molar for obtaining extrusion (Figure 5).
From left to right, progressive recovery of the maxillary canines.
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From left to right, progressive recovery of the mandibular canine.
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