The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
MBT system in orthodontics /certified fixed orthodontic courses by Indian den...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Maxillary canine impaction / oral surgery courses /certified fixed orthodon...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
This lecture demonstrate the orthodontic management of impacted canines with SPEED Appliance (Self-ligating bracket).
A Segmented approach is describe as well as the use of cantilever auxiliary spring to pull the canine. One example surgical exposure of impacted canine is shown. The alternative use of removable appliance and cantilever spring prior to the fixed appliance is presented.
The main purpose of our study is to present the corrective movement of impacted canines using various surgical-orthodontic techniques Materials and method: Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. For this study we used only the batch of patients who presented upper impacted canine. Depending on the clinical status, we used the following surgical techniques: repositioned flap, gingival translation flap, window flap method and local mesh application. After surgery for 39 patients we considered that canine traction with an orthodontic device was necessary in order to obtain a vertical position of the teeth. The orthodontic systems used were: fixed orthodontics, with a Titanium Button with chain by Watted (Dentaurum). Results and discussion: We used the repositioned flap for 39patients with deep impacted canines in order to uncover the teeth and to bond an auxiliary orthodontic device, the gingival translation flap for 27 patients with superficial impacted canines: 10cases with apical translation and 2 with lateral and apical translation. The window flap was used for 22 patients with palatal impaction. After surgery all patients continued orthodontic treatment in order to correct every dental malposition and to obtain a neutral occlusion with esthetical, functional and stabile results.
Treatment concept by Watted for a controlled alignment of palatally impacted ...Abu-Hussein Muhamad
It is known that maxillary canines remain impacted more often than the mandibular canines, and the inclusion can be
buccal or palatal. The treatment focuses mainly on the exposure and on the orthodontic realignment of the impacted
tooth. There are situations when canines erupt spontaneously after their surgical discovery. The present paper has the
purpose of approaching aspects related to impacted upper permanent canines by a literature review, including
localization and treatment conducts.
Key words: Impacted canine, periodontal, surgical-orthodontic treatment.
Magnets in ortho dontics /certified fixed orthodontic courses by Indian denta...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Copy of biographical account of dr. angle /certified fixed orthodontic course...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Magnets in orthodontics /certified fixed orthodontic courses by Indian denta...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Visualised treatment objective /certified fixed orthodontic courses by India...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Introduction
Incidence
Development of canine
Eruption of canine
Etiology of canine impaction
Sequelae of canine impaction
Classification of canine impaction
Diagnosis
Radiographic Prediction
Prognosis
Prevention of maxillary impaction
Extraction of impacted canine
Treatment alternatives
General principles of mechanotherapy
Methods of gaining space
Anchorage considerations
Surgical Methods
Surgical exposure for natural eruption
One step vs two step
Types of flaps
Attachments
Methods of traction
Mandibular canine impaction
Canine impaction and resorption
Canine impaction and periodontium
Retention
Complications of treatment
Complications of untreated impacted canine
Conclusions
References
The maxillary canine is the second most impaction of the oral cavity and this presentation I describe some etiology the interfere of normal eruption path of the maxillary canine.
presentation about impacted canine incidence, prevalence,classification,diagnosis, localization and treatment options including surgical and non surgical modalities
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Management of impacted teeth /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Canine Impaction and Its Importance in OrthodonticsAnalhaq Shaikh
Canine Impaction, Its Importance in Orthodontics, Etiology, Diagnosis and Management.
by Dr Analhaq Shaikh, 2nd year Postgraduate student, Sharavathi Dental College and Hospital, Shimoga, Karnataka
Canine Impaction can also be termed as Shy Canine.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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Dear Doctor,
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Course includes:
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Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
3. INTRODUCTION
Ectopic eruption and impaction of maxillary permanent
canine is a frequently encountered clinical problem.
IMPACTION is the Greek word derived from IMPACTUS.
DEFINITION ;-
A tooth whose roots are 2/3 or fully developed but
neverthless expected to erupt.
Canine impaction is next common to mandibular third molar
impaction. Mandibular second premolar is second to
maxillary canine impaction
www.indiandentalacademy.com
4. DEVELOPMENT OF CANINE
• Dewel (1949) stated that “no tooth is more interesting
from the development point of view than the maxillary
canine”
• Canine develops in deepest area of maxilla, has
longest path of eruption, travels 22mm during its
course or eruption and has longest period of
development.
www.indiandentalacademy.com
5. Develops at 30th
week (i.u.l)
Calcification ;- begins around 4 - 5 months of age
Eruption ;- left behind the roots of deciduous
molar
Around 6 -7 years of age calcification will be
completed.
www.indiandentalacademy.com
6. INCIDENCE OF CANINE IMPACTION
• Dachi and Howell (1961) incidence of maxillary canine
impaction - 0.92% .
• Ericson and Kurol (1986) - 1.7%
• Johnston et al (1982) – greater incidence of palatal
impaction than the labial
• Gaulis and Joho (1982) -2:1 ratio of palatal to buccal
impaction.
• Of all patients with maxillary impacted canines, 8% have
bilateral impactions & twice as common in females (1.7%)
than in males (0.51%)www.indiandentalacademy.com
7. ETIOLOGY OF IMPACTED CANINE
MOYER’S CONCEPT SUMMARISED BY BISHARA
Primary causes
A. Decreased rate of root resorption of deciduous teeth.
B. Trauma of deciduous tooth bud.
C. Disturbance in tooth eruption sequence.
D. Availability of space in the arch .
E. Premature root closure.
F. Canine eruption into the cleft area in cleft palate cases.
- Bishara & associates
www.indiandentalacademy.com
8. Secondary causes
A. Abnormal muscle pressure.
B. Febrile disease.
C. Endocrine disease
D. Vitamin D deficiency.
E. Irradiation
- Bishara & associates
www.indiandentalacademy.com
10. GUIDANCE THEORY BY MILLER
NORMAL ERUPTION;- TIMELY AND NORMAL DEVLOPMENT
OF A LATERAL INCISOR AND GUIDANCE FOR CANINE IS
PROVIDED
FIRST STAGE IMPACTION ;-
LOSS OF GUIDANCE AT A CRITICAL TIME IN THE NORMAL
DEVLOPMENT OF THE PERMANENT CANINE, WHICH LEADS
TO DEFLECTION OF DEVLOPMENTAL PATH OF THE TOOTH,
CAUSING IT TO MOVE PALATALLY
www.indiandentalacademy.com
11. FIRST STAGE IMPACTION WITH SECONDARY
CORRECTION ;-
IT GOES ON TO EXPLAIN THE CORRECTIVE
INFLUENCE OF THR VERTICAL ALVEOLAR
PROCESS, WHICH REDIRECTS THE CANINE ON A
MORE FAVOURABLE PATH.
SECOND STAGE IMPACTION ;-
SELF CORRECTION IS PREVENTED BY PRESENCE OF
LATE DEVELOPING LATERAL INCISOR,
REDEFLECTING THE TOOTH FURTHER PALATALLY
SECOND STAGE IMPACTION AND SECONDARY
CORRECTION ;-
EXTRACTION OF DECIDUOUS CANINE OR EVEN
LAT.INCISOR MAY OFTEN LEAD TOSPONTANEOUS
ERUPTION OF IMPAC.TOOTHwww.indiandentalacademy.com
13. Classification by ACKERMAN and FIELDS in 1935.
IMPACTED CANINE
Horizontally vertically
Palatal
Above
Labial
Mid- alveolar
Below
( With respect to the arch)
(With respect to the apex)
(J CO 1979 DEC)
www.indiandentalacademy.com
14. Classification of palatally impacted canine
The classification is based on two variables:
(1) Transverse relationship of the crown of the tooth to
the line of dental arch which may be
(a) Close
(b) Distant ( nearer the midline)
(2) Height of the crown of the teeth in relation to the
occlusal plane which may be
(a) High
(b) Low www.indiandentalacademy.com
15. Group 1 - Proximity to the line of arch – close.
- Position in the maxilla – low.
Group 2 - Proximity to the line of arch – close.
Position in the maxilla – forward , low &
mesial to the lateral incisor root.
Group 3 - Proximity to the line of arch – close.
- Position in the maxilla – high.
www.indiandentalacademy.com
16. Group 4 - Proximity to the line of arch – distant.
- Position in the maxilla – high.
Group 5 - canine root apex mesial to that of lateral incisor or
distal to that of first premolar.
Group 6 - Erupting in the line of arch in place of and resorbing
the roots of incisors.
www.indiandentalacademy.com
18. SEQUELAE OF IMPACTION
• Labial or lingual malposition of the
impacted tooth.
• Migration of the neighbouring teeth
and loss of arch length.
• Internal resorption.
• Dentigerous cyst formation.www.indiandentalacademy.com
19. • External root resorption of the
impacted tooth, as well as the
neighbouring teeth.
• Infection particularly with partial
eruption.
• Referred pain.
• Combination of the above sequelae.
www.indiandentalacademy.com
21. CLINICAL METHOD FOR
DIAGNOSIS
o Delayed eruption of permanent canine.
o Prolonged retention of deciduous canine.
o Absence of normal labial canine bulge.
o Presence of palatal bulge (Abnormal).
o Delayed eruption, distal tipping or migration of lateral incisor.
www.indiandentalacademy.com
22. RADIOGRAPHIC METHOD FOR DIAGNOSIS
In Orthodontic treatment planning, the exact localization of
the position of an impacted canine is necessary.
Periapical
Max. ant. occlusal True vertex/occlusal
OPG Lateral ceph
Extraoral
I. Qualitative radiographs
Maxillary arch Occlusal
PA view
www.indiandentalacademy.com
23. Parallax method
II. 3-D diagnosis of the position
C T scanning
Radiographic views at right angles
www.indiandentalacademy.com
25. Periapical Radiography-
• Are the simplest and the most informative X-ray films.
• As this view passes through minimum of surrounding
tissues, it gives accuracy & quality of resolution.
• It is aimed to be perpendicular to an imaginary plane
bisecting the angle between the long axis of an erupted
tooth and the film plane to produce minimum distortion.
www.indiandentalacademy.com
26. The periapical film gives the following information:
[1] Presence or absence of impacted tooth.
[2] Stage of development.
[3] Presence & size of follicle.
[4] Indicates crown or root resorption, resorption pattern
& integrity.
[5] Indicates presence or absence of supernumerary tooth.
[6] Indicates soft tissue lesions like cysts.
www.indiandentalacademy.com
27. OCCLUSAL RADIOGRAPH
1.Maxillary anterior occlusal
• In the maxillary arch, the nose and forehead interfere with
the positioning of x-ray tube close to the area to be viewed.
• The best that can be achieved by positioning the tube close
to the face,so that it becomes high and steeply angled view.
www.indiandentalacademy.com
28. 2. Ture vertex / occlusal
• A true vertex view is one which passes parallel to the long
axis of central incisors.This is possible if the cone is placed
over the vertex of the skull to produce vertex occlusal film.
• Since the beam has to travel a great distance there is loss of
clarity. www.indiandentalacademy.com
30. Extraoral Radiography:
• OPG has the advantage of simplicity & quickly
offering a good scan of the teeth & jaws from
Temporomandibular joint to Temporomandibular joint.
www.indiandentalacademy.com
31. • True lateral extraoral view is also used for localization
of impacted teeth, however the results are misleading.
• True P-A view defines the buccolingual relationship of
an object.
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32. Parallax method:
By Clark & Richards
Based on binocular principle.
• Useful in distinguishing the buccal or lingual
displacement of the canine.
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33. Procedure:
1. In the periapical film, the X-ray is taken in the area
of interest with the X-ray beam passing perpendicular
to a tangent to the line of arch at this point & at an
appropriate angle to horizontal plane.
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34. 2. In the second film, the X-ray tube is shifted mesially or
distally round the arch but held at the same angle to the
horizontal plane.
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35. Result:
• It is based on the SLOB principle.
• If the object has moved on the same side as that of
the X-ray tube, it is lingually placed & if it has
moved on the opposite side it is on the buccal side
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36. Radiographic views at right angles:
1. A true lateral view {e.g. Lateral
cephalograph} gives information
regarding the antero-posterior &
ventral location of an object . However,
it gives no information regarding
bucco-lingual {transverse} plane of an
object.
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37. 2. A true occlusal view will provide information in the
transverse & antero-posterior direction of an object .
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38. 3. True postero-anterior view defines
the ventral plane & buccolingual
relationship of an object.
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39. These views provide complete information regarding 3
planes of space of any impacted teeth
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40. CT Scanning:
By Ericson & Kurol
• Used to diagnose the exact
position of an impacted
tooth.
• Clear serial radiographs
may be taken at graduated
depth in any part of human
body in this method.www.indiandentalacademy.com
41. • This technique allows the
elimination of superimposition of
other structures.
• It is however rarely used in the
diagnosis of impacted teeth because
of
( 1) Large radiation dosage.
(2) High cost.
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43. Prognosis (Ericson & kurol)
Deep infraosseous location of impacted canine can be assessed
on panoramic image
CRITERIA
The midline
Occlusal plane
Long axis of incisors,1st
bicuspid and impacted canine
Angle between long axis of impacted canine and midline
Distance between the cusp of the impacted canine and the
occlusal plane.
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44. Evaluation
Most medial position of the crown is identified and severity of
the overlap assessed.
Canines placed mesial to lateral incisor, distal to premolar =
success rate is less
Angulation between long axis of canine measured in relation to
the midline.
Angulation greater than 40° shows poor prognosis.
Vertical height in millimeters from the canine tip to the occlusal
plane greater than 15mm reveals poor prognosis.(Avg treatment
time ≤ 14 mm = 24M, ≥14mm = 31months)
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45. PREVENTION
Before the age of 11 years will normalize the
position of ectopically erupting permanent canine
in 91% of the cases, if crown is distal to the
midline of lateral incisor.
Success rate is only 64% if the crown is mesial to
the midline of lateral incisor.
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46. TREATMENT ALTERNATIVES
1. No treatment, if the patient does not desire it. it should be
periodically evaluated.
2. Auto transplantation of the canine.
3. Extraction of impacted canine and moving premolar in
its position.
4. Extraction of the canine & posterior segmental
osteotomy to move the buccal segment mesially to close the
residual space.
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47. 5. Prosthetic replacement of the canine, not amendable
for juvenile cases.
6. Most desirable approach is surgical exposure of the
canine followed by orthodontic treatment .
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48. WHEN TO EXTRACT AN
IMPACTED CANINE
* If it is ankylosed & cannot be transplanted.
* If it is undergoing external or internal root
resorption.
* If the root is severely dilacerated.
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49. If the occlusion is acceptable, with first premolar in
canine position.
If there are pathologic changes {cystic formation,
infection}.
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50. PALATAL VERSUS LABIAL IMPACTIONS
• Incidence - Palatal : Labial is 2:1 or 3:1.
• Ectopic labially positioned canines may erupt on their own
without surgical exposure.
• Palatally impacted canine seldom erupt without surgical
intervention due to thick palatal cortical bone & dense &
resistant palatal mucosa.
• Palatally impacted canines are more often inclined in a
horizontal / oblique direction .
• Labial impactions are more often vertically inclined.
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51. Palatal displacement of canine and maxillary
skeletal width ( ajo, apr.06)
By Marayam,Rose,Joe
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52. In a multivariable analysis, there was no statistically
significant difference between subjects with PDC and subjects
with spontaneous canine eruption in (1) J-J,
(2) J-J/AG-GA, (3) AG-GA J-J, (4) NC-NC, and (5)
maxillary intermolar width.
There was a statistically significant difference in Ca-Ca between
PDC subjects and those with spontaneous canine eruption.
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53. Further analysis of data showed that the
absence of maxillary deciduous or permanent canines
in the dental arch (whether due to extraction, exfoliation,
impaction, or not yet having erupted) was associated
with smaller Ca-Ca.
Decreased Ca-Ca is a result of the eruptive status of
deciduous or permanent canines rather than the cause of
impacted canines. These findings suggest that Ca-Ca is
not a good predictor of palatal canine displacement.
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54. Peridontal considerations
Mcdonald and Yap evaluated the relationship between the
amount of bone removed during surgical procedure and
subsequent bone loss around impacted tooth after
treatment
Kohavi et al compared the periodontal health of impacted
canine exposed by the radical exposure and exposed by a
more conservative light exposure.
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55. Exposure of the CEJ is a critical variable and should be
avoided as an objective during surgery.
Kohavi et al suggested that light movements like tipping
cause less bone loss than heavy movements (torque)
during the traction of impacted tooth.
Combined effects are beneficial to the future periodontal
health of tooth.
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56. TYPES OF FLAPS FOR IMPACTED CANINE
• Exposure only
• Exposure with pack
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57. Circular incision
Buccally accessible impacted
teeth
Made on the sulcus mucosa
immediately over the crown,to
expose the the bony crypt,
which lodging the impacted
tooth.
Advantages:
Easy to perform
Suitable access can be provided
for bonding of the attachment
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58. Disadvantages:
a) elongated clinical crown
b) buccal positional relapse
c) On the labial side tooth will be invested with thin oral
mucosa rather than attached gingiva.
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59. Apically repositioned flap
This method was proposed by
Vanarsdall and corn in 1977.
In absence of the deciduous
canine , flap is raised from the
crest of the ridge that includes
attached gingiva.
In presence of deciduous canine,
flap is designed to include the
entire buccal gingiva that invests
it.
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60. In either case, flap is detached from the underlying hard tissue
Some way up to sulcus, to expose the crown.
Flap is then sutured to the labial side of the permanent canine to cover
the denuded periosteum and overlying cervical portion of crown,
while the remainder of crown remains exposed.
Advantages:
Maintains the width of attached gingiva.
Easy access for bonding of the attachment
Tooth can be visualized from the time of exposure still it come to
occlusion.
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61. Disadvantages:
Vermette in 1995 ,found several drawback in relation to aesthetic and
Peridontal results of apically repositioned flap
1) Uneven and unesthetic gingival margin
2) Increased Clinical crown length
3) Some degree of attachment loss and bone loss on the labial
surface, which was considered as possibly related to an increased
potential for plaque accumulation
4)Vertical orthodontic relapse: - After apical repositioning , the
gingival tissue heals to the adjacent mucosa, producing soft tissue
band of gingival scarring. As the tooth is pulled incisally this mucosa
get stretched down with it, toward the alveolar crest. Thus it tend to
relapse once the force is released.
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62. Full flap closure
This method was proposed by
MCBride in 1979.This method is
more effective for buccal and
palatally impacted tooth
Procedure:
A full buccal surgical flap is
raised as high as necessary to
expose the canine. An attachment
with a twisted thread is bonded to
the tooth and the flap is sutured
back to its former place itself..
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63. Then a Twisted thread drawn inferiorly through the sutured edges of
the replaced flap at the crest of the ridge or through the socket
vacated the extracted deciduous canine.
Advantages:
Tooth can be erupted towards and through the attached gingiva
which maintains the width of the attached gingiva.
b) No gingival scarring and good periodontal attachment is
established
c) No vertical relapse
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64. d) Immediate traction possible
e) Less discomfort and good post operative Haemostasis
Disadvantages:
Placement of the bonding attachment is necessary at the
time of exposure.
If there is a bond failure it needs re-exposure.
Difficulty in gaining dry field.
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65. GENERAL PRINCIPLES OF
MECHANO-THERAPY
The appliance should have the capability to level and rotate
all the teeth in same jaw rapidly, and with controlled crown
and root movents.
To open adequate space to accommodate the impacted tooth.
This stage requires the use of fine leveling and aligning arch
wires.
With the initial alignment achieved and no further movement
of individual erupted teeth needed, these teeth are
transformed into a composite and rigid anchorage unit, this is
done by substituting the flexible arch wires with a heavier
wire.
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66. The surgical exposure of the crown of the impacted tooth
should be performed in a manner that will achieve a good
periodontal prognosis of the treated result. An attachment is
bonded to it and the flap fully closed, with only a fine
ligature wire leading through the gingival tissue to the re-
covered tooth.
Using an auxiliary means of traction from the now rigid
orthodontic appliance, a gentle and continuous light force,
with a wide range of activity, is applied to the tooth, and is
aimed at erupting the impacted tooth.
5.There should be final detailing of the position of the
formerly impacted tooth.
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67. Attachments: –
Lasso wires
Threaded pins
Orthodontic bands
Standard orthodontic bracket
A simple eyelet
Elastic ties and modules
Magnets
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68. {a} Lasso wires:
It is twisted lightly around the neck of the canine.
Disadvantages:
This results in irritation of the gingiva
Prevents reattachments of the healing tissues in area of
CEJ (cemento-enamel junction).
May produce areas of external resorption & ankylosis in
areas of CEJ.
So, it is rarely used now.www.indiandentalacademy.com
69. (b) Threaded Pins:
Provide the attachment for
an impacted tooth.
Disadvantages:
- Dentaly invasive.
- Requires a subsequent restoration.
- Difficult to place along the long axis of the tooth because of
smaller surgical exposure.
- The drilled hole may inadvertently enter the pulp(unerupted
teeth may have large pulp chambers).
So it is rarely used. www.indiandentalacademy.com
70. {c} Orthodontic bands:
They largely replace the
Lasso wires & threaded pins.
Advantage:
They are compatible with the health of periodontal
tissues.
Disadvantage:
- Large surgical field required.
- Inadequate moisture control may hamper with the
cement-band bond.
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71. {d}Standard orthodontic brackets:
Any edge-wise , Begg’s , PAE brackets can be
used.
They are routinely used as direct attachments along
with the composites.(MIP Adhesive)
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72. Disadvantages:
- As the bracket base is wide, it is difficult to adapt to
any other tooth surface except for the buccal surface.
- The bracket’s shear bulk creates irritation as the tooth
is drawn the soft tissues.
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73. - Interferes with the investing tissues & leads to
inflammation & periodontal damage.
- As the impacted tooth advances into the arch
the exuberant gingival tissues bunches in front of it &
causes punching between the bracket & tissues.
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74. {e} A simple eyelet:
- An eyelet welded to band material with a mesh backing is
soft & easy to contour, making its adaptation to bonding
surface more accurate.
Advantages:
- Because of small size they can be placed in more
awkwardly placed teeth.
- It is less irritating to the surrounding tissues.www.indiandentalacademy.com
75. (f) Elastic ties and modules
Advantages
- Application of light forces
- Good range of action
- Easier to tie
Disadvantages
- Tends to loosen
- High degree of force decay
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76. {f} Magnets:
It is made up of rare earth lanthanide alloys .
• It is rarely used.
Disadvantage:
- corrosion.
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77. MECHANOTHERAPY
Various methods have been used for moving the canine in to
proper alignment with following considerations:
• The use of light force (not more than 60 - 150 gms).
• Creation of sufficient space.
• Maintenance of the space.
• Arch wire of sufficient stiffness.
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79. Ballista Spring
•It is tied into the head gear tubes of 1st molar.
•It proceeds forwards until it is opposite the canine space, at this
point , is bent vertically downwards terminating in a small loop.with
light finger pressure, the vertical portion is turned upwards, across
canine space and tied into the pigtail ligature.
In this way torque is introduced into the horizontal part of the
ballista, which is resisted great extent by the molar.
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81. 2) Active palatal arch (Becker1978)
It consist of fine 0.020 inch removable palatal arch wire
carrying an omega loop on each side. End of the wire is doubled
for Friction fit in lingual sheath.It is activated by elevating
downward and hooking the pigtail ligature around it
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82. 3) Light Auxiliary Labial Arch (Kornhauser1996)
It is made up of 0.014 inch round SS wire with vertical
loops in the area of impacted canine on both sides.This loop has a
small helix.This wire is tied with the basal arch wire in piggyback
fashion.If basal arch wire is not used it will leads to extrusion of
adjacent tooth and cause alteration of occlusal plane .
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83. CANTILEVER SPRING
• Lindauer and Isaacson (1995)
• TMA .017 X .025 wire used
• Force generated was measured
by dontrix guage.
• It should not exceed 70gms.
JCO Feb 1999www.indiandentalacademy.com
84. TMA BOX LOOP
• TMA .017 X .025 wire
used.
• Produce sagittal and
horizontal corrections while
continuing vertical eruption.
Surendra Patel J C O 1999
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85. NICKEL TITANIUM CLOSED-COIL SPRING
Loring L.Ross (1999)
• 0.009”X 0.041” spring
• Provides 80 gm of force when stretched to twice
its resting length
JCO Feb 1999www.indiandentalacademy.com
87. TWO ARCH WIRE TECNIQUE
• Samuels.R.H.A (1997)
• Gold chain is preferable because of
flexibility and biocompatibility.
JCO March 1997www.indiandentalacademy.com
88. An .014" nickel titanium archwire is used for attachment
to the gold chain, and a main archwire is placed in the
same bracket slots, over the traction archwire, for
anchorage and control of the archform.
The nickel titanium wire should be cut so that it passes
through two or three brackets on either side of the
impacted tooth. It is held in place with two or three
elastomeric ligatures.
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89. The traction archwire should be deflected 3-4mm toward the
gold chain at the traction site and tied to the chain with a
soft stainless steel ligature.
Traction to the gold chain is reactivated every four to six
weeks by removing links of chain and retying the chain to
the traction archwire
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90. THE MONKEY HOOK
S.Jay Bowman (2002)
• It is a simple auxiliary with an open loop on each
end for the attachment of intra oral elastic or
elastomeric chain or for connecting to a bondable
loop button. JCO July 2002www.indiandentalacademy.com
91. A combination of monkey hooks and bondable loop-
buttons allows the production of a variety of different
direction force such as:
I. Vertical intermaxillay eruptive forces
JCO July 2002www.indiandentalacademy.com
92. II. Vertical intra arch eruptive forces
JCO July 2002www.indiandentalacademy.com
94. THE K- 9 SPRING
•Varun Kalra (2000)
• Made in 0.017”X 0.025”TMA wire
Adv:
• Simple in design
• Low cost
• No patient compliance
• Light continuous eruptive and distalizing
forces
JCO Oct 2000www.indiandentalacademy.com
99. AUSTRALIAN HELICAL ARCHWIRE
• Christine Hauser (2000)
• Made in special plus .016”
arch wire
• Force should not exceed
200 gm
• Activation by twisting the
steel ligature wire every
two weeks
JCO Sep 2000www.indiandentalacademy.com
100. The amount of force can varied by using different
arch wire designs
JCO Sep 2000
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103. Tunnel traction of infraosseous
impacted canines
A.crescini et al(1994)
Adv:
• No attachment loss
• No recession
AJO 1994
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104. Full thickness flap raised ( Impacted tooth exposed)
↓
Deciduous canine extracted
↓
Socket is extended and widened sufficiently to allow passage of fine
wire through it
↓
An eyelet attachment on steel mesh is threaded with 0.011’’ligature
wire bonded on impacted canine
↓
Surgical flap resutured to its former position
↓
Formed tunnel is used for traction
↓
Traction phase started after one week and directed to the center of the
alveolar ridge.
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105. RETENTION CONSIDERATIONS
Evaluation of post treatment alignment by Becker et al
• Incidence of rotations and spacings
1. Impacted side- 17.4%
2. Control side 8.7%
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106. To minimize rotational relapse, options available are
1. Fiberotomy
2. Bonded fixed retainer
This can be done during or after the treatment.
Clark’s suggestion for palatally impacted canine: Lingual
drifting can be prevented by removal of halfmoon- shaped
wedge of tissue from lingual aspect of canine.
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108. CONCLUSION
Orthodontic management of impacted canines can be
very complex and requires a carefully planned inter-
disciplinary approach.
As canine has unique functional and aesthetic
importance,clinicians usually elect to bring an
impacted canine into proper position to give a better
smile. www.indiandentalacademy.com