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Management of Ectopic Maxillary Canines: Strategies for Orthodontic Alignment

Dr. Brad Williams / ,

Maxillary canines, due to their critical functional and aesthetic roles, are a focal point in comprehensive orthodontic treatment. Ectopic positioning—whether buccal, palatal, or high in the arch—poses a challenge for alignment.1 This article explores methods to create space, expose impacted canines, and guide their eruption, with considerations for preserving keratinized gingiva and addressing different alignment strategies based on cephalometric and occlusal variations, such as CCW growth/deep bite and CW/open bite scenarios.2

Creating Space for Ectopic Canines

Creating adequate space is the first step in managing blocked-out canines. Space creation often precedes surgical exposure, as it may encourage spontaneous eruption, potentially eliminating the need for surgery.3

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Dr. Brad Williams

Dr. Bradford R. Williams practices in Skiatook, Oklahoma, where his family has been residents for over 70 years. He graduated from The University of Oklahoma College of Dentistry (OUCOD) in 1982, and while in school, he was a contributing clinician to the Herbert T. Shillingburg, Jr., D.D.S. textbook entitled, Restoration of Endodontically Treated Teeth. He has practiced general dentistry since 1982 and general practice orthodontics since 1983. Today, Dr. Brad remains very active in the AOS, having previously served on their Board of Directors. In 2009, he was awarded AOS Fellowship and became a member of the AOS Academy of Diplomates in 2010. Currently, he is the AOS Senior Instructor for the Basic and Intermediate courses in Non-Extraction Straight Wire Orthodontics previously taught by the late Dr. David Jackson and the late Dr. Robert Gerety.

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