Hello doctor,
I have a confusion on pulling down an impacted left upper canine. One doctor said we can pull down left upper canine using bracket and braces other said no because roots are not yet formed.
Hi,
Welcome to icliniq.com.
Regarding the impacted left upper canine, I have looked at your CBCT and OPG (attachment removed to protect patient identity). A vital piece of information. The age of the patient is not available. However, according to the present data, the upper left canine is not completely formed and also has a bend in the root. It is also placed at a much deeper and more difficult location. It can be brought down into the arch with surgical exposure and braces.
However, there are certain risks with such teeth. Somtimes the tooth is joint with bone compounded by the bend in the bone and so does not respond to the pressure. In such a case, it will have to be extracted. This happens in extremely less number of cases. So it is a risk worth taking for the canine tooth since it is a very important tooth. Younger the patient, better chances.
Thank you doctor,
He is my son, 14 years old. How to know whether it is attached to bone? How will the bent and not completely formed root affect the pull down by braces and bracket? Our family doctor asked to consult a dental surgeon who told to leave that tooth as it is and treat other teeth. While other orthodontist told that they include that left upper impacted tooth too in the orthodontics treatment. This is the confusion.
Hi,
Welcome back to icliniq.com.
There is no way to know if it might be ankylosed or joint to bone. Usually the chances of ankylosis are higher if there is a bend (dilaceration). This is a decision you have to make knowing the pros and cons as I mentioned. Pro is that the canine is very important tooth especially in this young age. Ankylosis is not very common.
Cons are cost of surgery, difficult to bring down the tooth due to bend. If tooth is ankylosed, it will have to be extracted and treatment plan will change. Root not being completely formed is a benefit rather than disadvantage.
Thank you doctor,
I will contact you after discussion with our doctor.
Thank you doctor,
We had been to our orthodontist. He said about making a surgical window and using spring brackets pulling down the impacted left upper canine and monitoring it regularly. But out of respect and anxiousness, we failed to clear one doubt.
1. What will happen if we leave the impacted upper left canine having less formed root and having bend root untouched as it is not creating any issue now and is not visible?
2. What is wrong in pulling a tooth like canine of which root is bend and less formed?
We as parents wish to solve the biological issue than its aesthetic aspect.
Hi,
Welcome back to icliniq.com.
1. There are certain complications like risk of cyst formation or infection that can happen leaving the upper left canine as it is.
2. There is nothing wrong in pulling a tooth down. It just might be difficult or may not happen due to possible ankylosis. Hence I advised that it is better to try and bring it down using braces and surgical exposure.
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