Correction of Class II division 2 with crowding and bilateral fully transposed impacted mandibular canines

Abstract

Abstract Background Maxillary canine impaction has been extensively reported, but studies of mandibular canine impaction are relatively few. Clinical studies and reports of experience treating mandibular canine impaction are of clinical benefit to both orthodontists and dentists. Aims This report introduces a Class II division 2 crowded case with severely impacted, fully transposed, mandibular canines treated by a non-extraction approach and mandibular arch expansion. Methods The completely transposed, impacted, mandibular canines were successfully aligned. The crowding was relieved by arch expansion and incisor proclination without obvious radiographic alveolar bone loss. The two severely labially displaced mandibular canines assisted in the expansion of the narrow mandibular arch. Results The maxillary and mandibular arches were expanded and well aligned, and Class II molar and canine relationships and a normal overjet and overbite were established. The mandibular canines were aligned in advantageous positions. There was no regional alveolar bone resorption around the mandibular canines. Conclusion The treatment approach provided an example of significant bone remodelling. Using the impacted mandibular canines for anchorage, the age of the patient provided an opportunity to adopt a relatively conservative and unique treatment approach which may be applied to relieve crowding.