Modified Cantilever System (MCS) for Early Distalization of Palatally Impacted Canine in an Adult—A Case Report

Abstract

Maxillary canine impaction is a malocclusion feature of very low prevalence (0.9%-2.2%) with a preponderance to females over males in the ratio of 2:1. However, when it presents, it is a complex orthodontic challenge. Treatment choices vary from no treatment to surgical exposure followed by orthodontic traction. Surgical exposure and orthodontic traction is an option that requires careful consideration of factors such as labiolingual position of the crown, vertical position of the tooth relative to mucogingival junction, amount of attached gingiva, and mesiodistal position of the crown. Age is an important factor in the prognosis of impacted maxillary canine treatment. Prognosis is lower in an adult compared to a younger patient and worsens with age. We report this case of impacted left maxillary canine (23) with palatal displacement in a young adult. A modified cantilever system was used for an early movement of canine from the lateral incisor which showed a grade II mobility. This along with controlled mechanics resulted in bringing the impacted 23 into class I position in the arch, thereby achieving a stable canine-guided occlusion within a period of 16 months.