What are buried canines?
Buried canines, also known as ectopic canines, do not happen often but they occur with regular frequency that I see 2 to 3 cases a year. These are canines that have veered off the proper eruption pathway and are now unable to erupt and are buried within the jaw bone.
Why canines are important?
Canines are important for 2 reasons. The first reason is esthetic in that the canines are part of the front six teeth and therefore are important for a natural smile. When the canine is missing, the premolar will take the position of the canine and now form part of the complement of front teeth. When that happens, the result is compromised. While using a premolar to replace a canine is a valid protocol in orthodontics, the esthetics is just not good enough.
The second reason is functional, when the canine is present, a functional bite known as canine disclusion is achieved. This removes the stress on the back teeth during chewing.
Treatment mechanics
Figure 1
Believe it or not, you can use an orthodontic force to actually move a buried tooth through bone and until it erupts into the mouth. This is done by attaching a special orthodontic bracket with a gold chain attached to it to the buried canine (Figure 1). The gold chain is then connected to the orthodontic appliance and the appliance is used to pull the canine downwards.
Figure 2
Over time, the tooth is sequentially exposed and “tracked” into the arch. Once this has been achieved, a normal orthodontic bracket is attached (Figure 2) and orthodontic treatment proceeds as a normal orthodontic case with the full complement of teeth.
It is important to note that to bring the canine into the arch takes approximately 1 year. In total, that means a longer orthodontic treatment time and patients must be sure that they are willing to undergo prolonged treatment.
Nevertheless, this author feels that the final result, which is a perfect smile is well worth the additional time and effort!!!
