Orthotown August 2018 - 19

I know you will get plenty of opinions, and basically none are right or wrong. I have brought
lots of canines in, including one similar to the lower canine, but I am not sure I would put this
gentleman through that work. Personally, I try to treatment-plan what I would do for myself or
one of my children.
In this case, I would propose the following:

christjl
Member Since: 02/07/13
Post: 3 of 3

Option 1: Expose and bring in upper right canine. Remove lower right canine. Close lower
space with either a TAD or Forsus-type appliance to maintain anterior teeth from moving distal.
It appears your midline is left on the lower, so it may improve with treatment. This option avoids
other extractions and prolonged treatment. The difficulty will be the upper right canine.
Option 2: If you do decide to remove the right canines, I would consider moving the premolars
into the canine position and then placing implants in the first premolar region. You can even do
it in the second premolar region if you want to hide the implant further. I would consider this
option more work than the first, and I would rather not deal with implants.
Option 3: Essentially four extractions, one in each arch. Lots of work to close this space and
I am not sure this is worth the work, either.
I think Option 1 is the way I would treat this case. Thank you for sharing.
P.S.: A pediatric dentist probably did the crown on the primary canine. Also did endo.
Patient must have had high caries rate as youngster. ■
3/27/2018

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