Traction Of Impacted Canine By Uprighting Root In Alveolar Bone

Orthodontic traction of severely inclined impacted maxillary canines with poor root position presents a challenge, particularly in avoiding damage to the roots of adjacent teeth or the impacted canine itself. This case report introduces a technique to upright the root of an impacted canine within the alveolar bone using a boot loop combined with a microscrew, minimizing the risk of root damage. A 14-year-old boy presented with a severely inclined impacted maxillary left canine, with the root apex positioned above the root of the maxillary left second premolar. Treatment aimed to upright the canine root during traction within the alveolar bone. A boot loop combined with a microscrew was employed to achieve this. This approach successfully corrected the canine’s inclination from a distal angle of 60° to a mesial angle of 13°, achieving a total angular correction of 73°. The impacted canine was repositioned to its normal position without signs of root resorption, gingival recession, or loss of supporting tissue. The boot loop design, resembling a single loop in the MEAW system, provided a gentler uprighting force due to the increased distance between the impacted canine and the microscrew compared to typical interbracket spans. This design allowed for effective and safe uprighting of the canine root. The combination of a boot loop and microscrew offers multi-directional forces that effectively control both crown and root movements, providing a reliable approach for managing severely inclined impacted canines.