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Operculectomy & orthodontics to align impacted canine tooth

22/6/2014

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A 15-year-old boy was brought to our dental clinic by his parents seeking to align his crookedly placed teeth. His upper right canine tooth had not erupted. A specialized 3D CBCT scan taken showed that the canine tooth was impacted i.e abnormally positioned high above near the roots of adjacent teeth.

The canine teeth are important in the dental arch as they frame the smile and play a critical role in biting and chewing. To bring the impacted tooth into proper alignment, an operculectomy was done. This is a surgical procedure in which the gum on top of the impacted tooth was removed to expose the hidden tooth underneath. Once the tooth was exposed, an orthodontic bracket was bonded to the exposed tooth. With subsequent orthodontic treatment, the tooth was brought into normal position maintaining its vitality and the teeth were aligned to improve function & appearance. 
Missing upper canine tooth in the right side
3D CBCT scan image showing buccally impacted canine tooth
After operculectomy and subsequent orthodontic treatment canine tooth was brought into occlusion
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Successful Operculectomy & Unerupted tooth brought to its normal position through orthodontics

18/3/2014

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A 10 year-old boy was brought to our hospital by his parents with a complaint of an unerupted upper front tooth. The front tooth on the right side had erupted normally but the tooth on the left side had not appeared.

A digital X-ray taken showed an over-retained deciduous tooth (milk tooth) preventing the normal eruption of the permanent maxillary left central incisor. The deciduous tooth was extracted and with the operculectomy procedure the thick overlying soft tissues were uncovered to expose the “hidden” permanent tooth. Using an orthodontic appliance, the tooth was brought down into normal position maintaining its vitality. This was performed at an earlier stage itself to prevent the impaction of central incisor. When all the milk teeth shed, orthodontic treatment will be done to align the teeth.
Preoperative intraoral view showing missing permanent upper left central incisor
Preoperative Xray showing retained impacted deciduous and upper central incisor
Impacted retained deciduous tooth removed surgically
Impacted upper permanent incisor exposed surgically
Postoperative Xray showing upper incisors brought to alignment
Postoperative clinical view with braces
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