message board Would You Extract All Canines? Townie "BenFolds" shows a case with some nasty canines. Extraction is a good option, but should spaces be closed? BenFolds Member Since: 03/27/13 Post: 1 of 3 Sorry for the terrible photos-the training of new assistants on photos is never finished! Patient is a 13-year-old Medicaid patient and his family is concerned about implant costs/finances. I'm not loving trying to bring in that LR3 or having to maintain that space from 13-21, though, when: 1. I'm not sure the patient will hold the space adequately until an implant can be placed at 21. 2. Will he care enough and will finances be available for possible touch-up braces at that time? 3. I don't love lateral excursive movements on an implant in the canine position. 4. Would prefer to maintain symmetry by substituting premolars for canines. (His upper premolars have a pretty good shape for substitution.) 5. The fact that he already has another impacted canine pushes me more toward an extraction plan. (Not ideal, but I feel his profile can tolerate it.) I know so many people (think: GPs) think canines are sacred, but I'm thinking extract all canines. (Extracting left 4s would result in tooth size and appearance discrepancies-just check out the size of those upper canines.) I explained the options of implants, versus extracting 4s on the left, versus extracting all canines, and dad is fine with extracting all canines. What would everyone here do? ■ 3/26/2018 dhmjdds Member Since: 11/16/04 Post: 2 of 3 Why do patients like this never have crowding?! I agree that extraction of the impacted canines is the way to go. You are going to have a bear of a time closing that much space in each arch-at least I certainly would. But planning for two implants or bridges for missing canines isn't a great plan in this situation, either. So I would vote for four canines. Treatment-plan him for at least 30 months-do you think he'll stick with it throughout? Who puts a SS crown on a maxillary primary canine? P.S. Both of your occlusal photos need to be mirror-flipped. ■ 3/27/2018 18 JULY/AUGUST 2018 // orthotown.comhttp://www.orthotown.com