Ectopic
canine

It is a kind of malocclusion in which the canine erupts in an abnormal place or position. Diagnosis of ectopic canines can be done via full mouth x-ray (OPG) as early as 10 years of age. Early diagnosis of maxillary ectopic canines is essential as delayed diagnosis may result in complications such as the resorption of upper incisors. It can be unilateral or bilateral. A cross-sectional study was done in prestigious dental colleges of Pakistan to find out the frequency of maxillary ectopic canine and their occurrence unilaterally or bilaterally. Out of 3500 radiographs of patients, 98 patients had ectopic canine (2.8%). 60 patients had unilateral and 38 patients had bilateral ectopic maxillary canine.

unilateral ectopic canine in maxilla

Bilateral Ectopic Canine In Maxilla

had ectopic canine out of 3500 readiographs

0 %

of population in Pakistan had ectopic canine malocclusion

Case
Study

A 20-year-old female presented with the chief complaint of the buccally erupted ectopic right maxillary canine and crooked teeth. She was also unhappy with her smile.

Clinical Examination

Extra-oral Examination

On the extra-oral examination, we found out that patient had a prominent nose and chin, retruded lips, and an unpleasant smile.

Intra-oral Examination

Intra-oral examination showed severe crowding. Lower second premolars were congenitally missing. There was no space in the upper arch for the right ectopic canine.

Treatment Objectives

This case was a challenging one because patient had already passed her growing age

Create Space

for ectopic Canine.

correction

of severe crowding.

correction

of Dished-in Facial profile because we needed lips to be supported with teeth in order to achieve straight pleasing facial profile.

Treatment Challenges

The patient traveled from a different city for her treatment, so frequent monitoring visits were not possible that’s why virtual monitoring was done on regular basis.

That was not the only challenge but 2 major challenges 3 relieve patient dental crowding.

01

Extractions were prohibited

Since the patient already had a dished-in facial profile, extractions for creating space for canine had to forbid, else it would have resulted in over retraction of front teeth causing reduced lip/facial support.

02

correction of severe crowding

The biggest challenge was to create space for correction of severe crowding almost 14 mm without extractions.

03

Establish Occlusal Harmony

Lower second pre-molars were missing therefore establishing occlusal harmony was another challenging task.

Damon's Bracket System

Damon’s non-extraction philosophy was applied with self-ligating Damon brackets.

Treatment Plan

Initially upper arch was aligned with heat activated NiTi wires.

alignment of upper archFirst Step

After alignment, the upper front teeth were protruded out which was giving support to upper lips as desired.

Protrusion of upper lipsecond step

BUT the biggest challenge was to bring lower teeth forward to achieve occlusal harmony. In order to achieve this, fixed functional appliance was given.

fixed functional appliancethird step

Target Achieved

and patient was highly satisfied and happy with her treatment.

Alignment

Ectopic canine was aligned without extraction.

Occlusal Harmony Regained

severe crowding was corrected without extraction.

lip support

lip support was regained by adjusting

It was indeed a difficult case

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Ectopic
canine

Case
Study

Clinical Examination

Extra-oral Examination

Intra-oral Examination