message board Impacted Mand Canine A young patient with a tricky canine lends to a variety of treatment options zxzxzx Member Since: 02/28/03 Post: 1 of 16 Here's a 11.5-year-old male who has an impacted mandibular left canine. I plan to bring it in as a first phase of treatment. Any thoughts or comments on things to be aware of, things I should or should not do? ■ 12/20/2016 justinudm Member Since: 09/29/14 Post: 2 of 16 I just saw one of these today that I was able to get in place. I would definitely warn that a connective tissue graft by the periodontist may be needed in the future if there is too little keratinized tissue. Also, would not bond LL2, so it's free to move as the canine is uprighted/ erupted. Also, tell the surgeon to get the chain bonded near the cusp tip to give you mechanical advantage when erupting the tooth. Good luck. ■ 12/20/2016 JamesBonding Member Since: 09/29/11 Post: 3 of 16 Would you plan to bond primary teeth for anchorage? What about an LLHA for anchorage? I inherited a case very similar to this and there was a lower lingual arch placed and it had proclined the mandibular anteriors into anterior crossbite. ■ 12/20/2016 justinudm Member Since: 09/29/14 Post: 4 of 16 I would use the LLD and LLE with bands on them. LLD premolar band with a regular bracket on it. LLE with LL6 band. Bond LL1-LR2. Band LRD and LRE the same. Arch wire LLE-LRE steel base archwire, with 14 NiTi piggybacked to most gingival loop on gold chain. If I wanted distal traction, I would run power chain looped through the gold chain back to the LLD/LLE. ■ 12/20/2016 zxzxzx Member Since: 02/28/03 Post: 5 of 16 Thanks to everyone for their responses. I am worried about losing the lower Ds before I can accomplish much. If the lower Ds are not usable, how would you change things? Thanks. ■ 12/20/2016 tcscotese Member Since: 11/17/08 Post: 6 of 16 16 I've done two of these within one year. Prior to that, zero in 35 years. A CBCT would be best before you do anything. While you can clearly see from the ceph that the cuspid is labial, you don't know how thin the labial cortex is on the rest of the anteriors. I'm a bit surprised that there is no JULY/AUGUST 2019 // orthotown.comhttp://www.orthotown.com