Tricks of the Trade: Palatal Canine Alignment during Functional Appliance Treatment

All Orthodontists aim to provide time efficient treatment for their patients. This clinical tip shortens treatment time as well as providing an anchorage reinforcing solution to a relatively frequent Orthodontic problem.

Orthodontists managing patients with ectopic maxillary canines, using fixed appliances, traditionally wait until they are in rigid stainless steel archwires before applying traction to the canine.¹ Some also advocate additional anchorage supplementation with TPAs or TADs, if the patient presents with high anchorage demands.²

It is well known that alignment of palatally impacted maxillary canines dramatically increases treatment times.³ Palatally ectopic canines not only occur in Class I occlusions, but are often seen in Class II division 1 and Class II division 2 malocclusions.⁴ In these patients, treatment times can be further increased if anterior-posterior (AP) correction is required, with a phase of functional appliance therapy prior to full upper arch fixed appliances, to align the ectopic canine.