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RESEARCH PRODUCT

Extraction of Impacted Maxillary Canines With Simultaneous Implant Placement

subject

description

When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only option available, followed by implant placement. If apical and ridge crest bone remains after the extraction of the maxillary canines, an immediate implant can be placed. The implant is anchored bicortically with good primary fixation. This article presents a new surgical technique that allows an immediate implant placement after the extraction of the maxillary canines. The full circumference of the implant is left without bone coverage, except for the apical and coronal area. The implant screw threads and the bone defect are covered with the bone shavings collected by the filter of the surgical aspirator during ostectomy. The case of a 32-year-old woman with impaction of both upper canines is presented. Right canine orthodontic traction was not possible because of high and horizontal impaction, and the patient was unwilling to receive orthodontic treatment. Therefore, extraction with the simultaneous placement of 2 dental implants was chosen. During ostectomy, bone shavings were collected by the filter of the surgical aspirator. Two implants were placed anchored bicortically in the sockets and floor of the nasal fossae and maxillary sinus, and the bone defects remaining around the implants were filled with the collected allograft shavings. When possible, impacted maxillary canines are subjected to fenestration and orthodontic traction. 1 If neither traction nor reimplantation is feasible, or the patient is unwilling to accept orthodontic treatment, extraction followed by dental implant placement is a management option. 2,3 If apical and ridge crest bone remain after the extraction of the maxillary canines, an immediate implant can be placed. The implant is anchored bicortically with good primary fixation. This case report presents a patient with impaction of both maxillary upper canines. The high and horizontal disposition of the teeth precluded orthodontic treatment. As a result, the canines were removed, with collection of the ostectomy bone shavings and immediate dental implant placement.