Initial panoramic radiograph- maxillary canines are impacted
3D image on CBCT of impacted canines
Clinical photo of initial presentation- typical presentation of a 9 year old’s upper arch
Clinical photo of canines erupting after open exposure surgical technique
Progress panoramic radiograph showing canines making their way to their proper spot
Canines erupted to the point where they are ready to be bonded and brought into their proper spot. Successful open exposure!
Progress panoramic radiograph, showing the canines bonded and in their proper spot!
As 2017 comes to a close and 2018 is right around the corner, many of us reflect on the year that has past and what our goals are for the next year. Whether it is a committment to healthy eating, more exercise, or getting more sleep (I need this one!), writing down your goals is always a good start to getting them accomplished. Sometimes difficult things come in our way, but taking them step by step is a good way to overcome them. Rome wasn’t built in a day, so breaking down bigger challenges into smaller components can be a very useful way to reach your end goal.
Take this patient’s tricky canines, for example…
This patient presented to us at 9 years old. From the initial panoramic radiograph, you can see that her maxillary canine teeth were in a precarious position and were impacted. This is one of the reasons why a panoramic radiograph is so important at this age- from the clinical view, it would appear that nothing is abnormal, while the x-ray shows a very different story! At this point, the patient was referred for a CBCT (3D radiograph) to show where the canines were located in the arch. Because of their position and the dental age of the patient, a decision was made to perform an open exposure surgical procedure. The patient was referred to an oral surgeon to perform the surgery- it was a success!
After the procedure, we closely monitored this patient for the eruption of the canines. You can see that the canines started to erupt on their own, into the palate of the patient. The open exposure is a great procedure, when used properly: the canines erupted without any help or orthodontic force, and it is less time in braces for the patient! When the canines erupted to the level of the occlusion, they were ready to be bonded. At that time, maxillary braces were placed, the primary (baby) canines were removed, and the adult canines finally reached their proper destination. Success!
As with other difficult situations or goals that we would like to accomplish, taking a step-wise approach like was done in this case can be a path to a successful result. What are your goals for 2018? What are the smaller steps that you need to take to accomplish those bigger goals?
Best wishes for a happy and successful 2018!