Mdt Of An Adolescent With Class II And Canine Impacted.

Surgical-orthodontic disimpaction of impacted canines can be a successful treatment choice. The fixed Twin Block appliance gives fast and excellent results for growth guidance and alteration in Class II division one malocclusion. This article describe an approach to class II malocclusion and a high bucco-lingually impacted maxillary canine with two-phase orthodontic treatment. This case presents a modified design of the Twin block combined with maxillary expansion appliance which can be used concurrently for closed-eruption guidance of the high-impacted canine by individual hooks. In this case, a 13 old male adolescent was treated with simultaneous use of fixed twin block along with fixed orthodontic appliance to correct both the skeletal and dental malocclusion in Phase I for 22 months. Subsequent Phase II of non extraction therapy to achieve final dental alignment and precision occlusal refinement by using clear aligner. CBCT analysis was very useful in analyzing the impaction status of the canine. Through this analysis, more careful consideration about the direction of the retraction force was possible. In Phase I treatment, the impacted canine was successfully erupted while promoting jaw growth. Depending on the direction and position of impaction, and timing and modality of the treatment, there are various prognoses for not only the impacted teeth but also the skeletal malocclusion. To obtain a successful outcome, careful and comprehensive treatment planning is necessary.