Exposure of Impacted Cuspids

The canines, or cuspids, are some of the strongest teeth with the longest roots in the mouth. During development, in some patients, canines may fail to erupt into the dental arch because of abnormal growth and crowding. The tooth is considered impacted when it is covered by surrounding soft tissue and bone. Orthodontists attempt to guide the canines to complete eruption because they play such an important role in a patient’s bite. The canine teeth can be impacted to the lip side or many times trapped on the roof of the mouth. Today, 3-dimensional Cone Beam Imaging (CBCT) can accurately locate the impacted canine which greatly aids treatment. Patients are referred to an oral surgeon to correct this problem. The procedure, performed under IV sedation, consists of making a small incision in the gums and locating the impacted tooth. Bone is removed and a gold bracket and chain are bonded on the tooth. A few weeks following surgery, the orthodontist will start pulling the tooth into the dental arch by placing a small rubber band on the chain.

One of the key factors for this procedure to be successful is the early identification of the impacted tooth. Impacted canines that are identified early have a high chance of erupting with surgical assistance. As the patient gets older, the chance of eruption with surgical assistance decreases. Occasionally, the bonded bracket can come off the impacted tooth, requiring additional treatment. The post-operative care with this procedure is very similar to simple tooth extraction, with minimal post-op discomfort.