“Canine First Technique”, An Innovative Approach in Maxillary Impacted Canines: A Case Report

Maxillary canine impaction is one of the most challenging issues in orthodontics. The best treatment protocol in these cases is still debated. The purpose of this study is to describe the management of maxillary canine impaction in an adult female patient with the “Canine First Technique”.

A 21-years-old female attended our dental unit seeking orthodontic treatment. Clinical examination revealed a class II relationship, the persistence of both upper deciduous canines. The panoramic X-ray and Cone Beam Computed Tomography showed bilateral palatal permanent canine displacements and close proximity between crowns of impacted canines and roots of lateral incisors. The canines were disimpacted by means of two cantilevers inserted directly in two Temporary Anchorage Devices placed palatally and when canines were near the crest, the fixed orthodontic treatment was started.

At the end of the treatment, canine Class I relationships with torque correction of canines, normal overjet and overbite, and good alignment of dental arches were achieved. The radiographic evaluation showed ideal root parallelism and preserved periodontal health in the canine region.

The Canine First Technique could provide some advantages compared to conventional approaches in terms of biomechanics, esthetics, oral hygiene, and risk reduction of root resorption of upper lateral incisors.