Orthodontic management of a patient with an impacted maxillary canine associated with severe palatal root dilaceration of the adjacent first premolar.

Abstract

The incidence of maxillary canine impaction is estimated at approximately 1.7% of the population and is multifactorial in etiology. Several case reports suggest a potential relationship between canine impaction and root dilaceration of the adjacent premolar, indicating mechanical interference due to their proximity. In such cases, when avoiding tooth extractions is desired, it is crucial to consider specific clinical approaches to prevent contact with the dilacerated root during traction. This case report describes traction of an impacted maxillary canine in a female patient resulting from severe palatal root dilaceration of the adjacent first premolar. The canine was surgically exposed and traction was initiated after endodontic therapy and root sectioning of the affected premolar. After 24 months of orthodontic treatment, the results were satisfactory, with adequate gingival contour, 2 mm overjet and overbite, and a Class I relationship of canines and molars. No apparent root resorption was observed, and bone structure was preserved. A multidisciplinary approach is fundamental for the success of treatment in such cases, enabling achievement of a functionally and esthetically stable occlusion while avoiding tooth extractions.