Exposure of Impacted Cuspids or Eye Teeth for Orthodontics
The canines or eye teeth are one of the strongest teeth with the longest roots in the entire dentition. During development many patients have the canines that fail to erupt into the dental arch because of abnormal growth and crowding. When a tooth is trapped in the underlying soft tissue and bone it is called an impaction. Most orthodontists make every effort to guide the canines to complete eruption because they play a critical role in a patients bite. The canine teeth can be impacted to the cheek side or many times trapped on the roof of the mouth (palate.) Patients are often referred for a simple surgical procedure to fix this problem. The procedure, usually done under IV sedation, consists of making a small incision in the gums and identifying the impacted tooth. Bone is removed and a bracket and chain is placed on the tooth. A few weeks after surgery, the orthodontist will attach a small rubber band to the chain and will start pulling the tooth into the dental arch. Some orthodontists request the surgeon to place the bracket and chain at the time of surgery while others place the bracket themselves.
One of the key principals for this procedure to be successful is early identification of the pending impaction. Impacted canines that are identified in late childhood or adolescence stand a very good chance of erupting with surgical assistance. As the patient ages the prognosis for surgically assisting the eruption of impacted canines tends to decrease. The post operative course and care with this procedure is very similar to simple tooth extraction. You may refer to pre operative and post operative instructions under Surgical Instructions for more information.