Guest
How would you fix an impaction like this? A 12-year-old male came with an impacted canine that can be pulsated on the labial side. The primary canine was retained in the arch. There are two important aspects of the thinking process when facing impaction. First of all, the age of the patient is 12 years old, which means the root is still forming, and that can provide eruption potential. Second, the direction of the impaction can be precisely located with the CBCT. So base on the age and direction, what would be your treatment plan? Since the impaction is located just above the primary canine, and the age indicated eruption potential, we decided to wait for primary canine to exfoliate, and use aligners to create space for the impaction. However, 9 months later, there was still no movement. So we decided to go for a surgical exposure. Now, which flap design would you choose? Since the impaction was not in a high position, and it was located just above the primary canine, it means a tunnel was not needed. We decided to perform Apical Position Flap. First of all, having a better access to position the button on the buccal side. Second, it’s an open window technique that can preserve enough keratinized gingiva. An IZC screw was inserted and connected with a 3D lever arm. The mechanics of the 3D lever arm activation is by pushing it with your finger onto the power chain. The tendency of the 3D lever arm wanting to bounce back to its original position can provide downward, forward, outward forces. The surgical details were indicated in this slide. With these 2 powerful weapons, the IZC screw plus 3D lever arm, we were able to get this result in just 2 months. And now we are ready to scan for refinement. To recap, the thinking process of impaction treatment is first through age and direction. And we came up with treatment plan A, using aligners to create space and wait for canine eruption. However, 9 months later, there was still no movement. So we decided to go for surgical exposure. The flap design was an Apical Position Flap, and the mechanics is by using IZC screw with the 3D lever arm. If you are interested in more impaction cases, don’t forget to subscribe. It’s all for your own good. We’ll see you in the next video. Bye bye.
