This case report described the treatment of a 16 y/o female who was referred for her bilateral maxillary impacted canines. Her chief complaint also involved lower crooked front teeth. She presented with skeletal Class I with orthodivergent facial pattern and dental Class II relationship. Clinical oral examination revealed two peg lateral incisors and two retained primary canines in the upper arch. The panoramic film showed two maxillary impacted canines near the center of palate. Before the orthodontic intervention, surgical exposure was conducted with open window technique. A transpalatal arch with 2 soldered hooks was inserted as anchorage for distal traction of the impacted permanent canines at initial stage. Teeth 53, 63 were extracted after successful crown portion exposure of the impacted canines. The ballista loops were activated for further vertical movement of the impacted canine prior to labial movement and rotation correction. Teeth 12, 22, 35, 45 were subsequently removed for correcting space deficiency and molar relation. Satisfactory treatment outcome was achieved with proper overbite and overjet, good interdigitation, bilateral Class I molar relationship and canine substitution with harmonious smile arc.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.