Orthodontic Combined Surgical Treatment Of Translocation Impacted Maxillary Canine

Objective: Using orthodontic combined surgical periodontal flap surgery, to tracte translocation impacted maxillary canine to the normal dentition position, and to investigate the treatment method of it.Methods: Select two cases malocclusion patients of Shenyang Orthodontics Dental Hospital in this study. Patients can take the initiative to undergo a surgical periodontal flap surgery with good compliance. The selected cases are permanent dentition. After clinical examination and radiographic analysis, maxillary canine translocation impacted between ipsilateral central incisor and lateral incisor, It’s crown near the maxillary mesial and 45 ° to the long axis of the maxillary central incisor. Canines root has been completed and canine apical foramen has been closed basically. It’s eruption underpowered and can’t eruption long time. Objective analysis of the reasons for the ambush impacted canines, grasp the impacted location and the periodontal tissue conditions around the adjacent teeth. Traction translocation impacted canines to normal dentition using fixed appliance combined surgical surgical flap surgery. Explore the tooth gap and arch as anchorage. Use elastic rubber chain light traction force about 60 g to traction translocation impacted canine to its normal position. Shooting the X-ray panoramic radiograph before and after treatment to observe the change of translocation impacted maxillary canine position change and the situation of it periodontal; Shooting cephalometric to measure the maxillary and mandibular and lip inclination of the incisors and the changes in the soft tissue facial profile.Results: Two cases selected article have achieved a satisfactory therapeutic effect. Two patients with an average treatment duration was 29 months. The translocation impacted maxillarycanine be tracted successful to the normal position of dentition by orthodontic combined surgical periodontal flap surgery and in good contact with the adjacent teeth. No protrusive occlusal and lateral occlusal interference and pulp vitality normal. Skeletal changes of typical cases before and after treatment: There have no obvious bone abnormalities. Condylar morphology is essentially the same on both sides. The angle SNA, NA-PA,MP-FH increased by 1.0°,3.5° and 4.0° respectively, ANS-Me /N-ME increased by 0.6%,Wits increased by 2.1mm,angle SNB, APDI, NP-FH decreased by 0.5°,7.5° and 9.0° respectively; Dental position changes of typical cases before and after treatment: The patient’s 13、34 all have been included in the dentition to its normal position. The root of 13 and 34 distal curved, the root of 22 and 23 tilted to the distal slightly. The others tooth root parallel to each other. No obvious root resorption. The angle U1-SN, U1-NA, L1-NB and L1-MP increased by 3.5°, 9.0°, 8.4°, and 6.0° respectively; Soft tissue changes of typical cases before and after treatment: Part of the papilla minor swelling, palatal gingival of 13 have no significant withdrawal and the rest were normal.Postoperative measurements show that FCA、ULP、LLP、EPUL、EPLL all have an increase, and NLA have an decrease. Z angle decreased from 79°to normal 73°. Lip protrusion of upper and lower are normal, which means the proportions of nose, lips and chin tends coordination, and facial profile beautiful.Conclusion: After treatment, the translocation impacted canine of typical cases is good contact with the adjacent teeth, with no bone and root absorption and pulp vitality normal; The patient’s upper and lower arch width and sagittal relationship are more coordinated, wherefore improves the soft tissue profile. Patient is very pleased with treatment efficacy; Using orthodontic combined surgical periodontal flap surgery, through diagnosing position and growth of the impacted tooth properly, masting traction timing and direction flexiblely, controling the torque straight wire appliance effectively, choicing reasonable anchorage, and forcing suitable size traction, to eruption translocation impacted maxillary canines can tracted it into normal position effectively, to achieve beautiful, balanced and stable treatment goals finally.