Orthotown October 2017 - 22
message board
Impacted LL3 (Extract?)
A Townie asks for advice about how to treat a lower canine
Pezortho
Member Since: 10/27/11
Post: 1 of 4
Here's a very nice girl I saw a few months ago. Note the impaction of the LL3. The rest of
her occlusion appears to be unremarkable. I have sent her to a local periodontist for a 3-D scan
to evaluate the position of LL3 and any possible root damage to LL2 or LLc.
Taking into consideration of length of treatment, functional and aesthetic outcomes and
possible resulting damage to other teeth and perio, I have advised her parents that my initial
impression is to extract LL3 and leave the deciduous tooth in place. (That is with the assumption
no damage to the root of LLc, of which there appears to be a little). After evaluating the scan, I
can finalize the decision.
I'd appreciate your input and advice and suggested tx plan. n
8/3/2017
Fesdds
Member Since: 05/22/08
Post: 2 of 4
I have saved tons of lower canines in situations like this. If it is mostly just in front of the
lower lateral incisor, I will typically save it. Pull to the distal to begin uprighting. It looks like
the root of the lateral is already lingual for you. As it gets closer to being in front of the central,
obviously you have to decide if it's worth it. Because they tend to upright into the proper space
just with a distal pull, I would start this one with an LLA, with loop in from the LLd or e to tie
the distal vector. Then by the time it's in, you can place braces, etc. If the cusp tip is past the
central, I would just plan on extracting. n
8/3/2017
pezortho
Member Since: 10/27/11
Post: 3 of 4
I just got the scan back; I hope these screenshots help. I am now encouraged that the canine
is facial to the incisors and there's nothing to impede the path of traction. I am now strongly
considering changing my initial treatment plan and leaning toward saving the canine. n
8/3/2017
Help your fellow orthodontists online!
The Orthotown message boards are filled with posts like this one, with Townies asking
their peers for advice and opinions about treatment plans. Participation is what drives
the community-so head to orthotown.com and share your feedback today.
22
OCTOBER 2017 // orthotown.com
http://www.orthotown.com/messageboard/thread.aspx?a=11&s=6&f=693&t=296846&g=1
http://www.orthotown.com/messageboard/thread.aspx?a=11&s=6&f=693&t=296846&g=1
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