Palatally Displaced Canine and Anterior Crossbite Management with a Combination of Palatal Flap Window and MEAW Technique: A Case Report

Canine impaction is a frequent problem, ranking third in occurrence behind the impaction of the mandibular and maxillary third molars. Palatally displaced canines (PDCs) require more comprehensive treatment and are more challenging to manage. This case report describes the management of a rotated palatally impacted permanent maxillary right canine using the open palatal flap window method and the multiloop edgewise arch wire (MEAW) technique. A 19-year-old female patient presented with dental misalignment, which included a skeletal Class I relationship with Angle Class I malocclusion, a protruding lower jaw, anterior crossbite, and the upper left canine being palatally impacted. The panoramic radiograph indicated the existence of a Type II impaction of the canine teeth (Yamamoto classification). The treatment employed the MEAW technique to expand the maxilla and handle an anterior crossbite. The palatal window flap technique was utilized to achieve access to the maxillary right canine by using a button chain and ligation to the upper archwire. The posttreatment outcomes demonstrated satisfactory eruption and alignment of the maxillary right canine, correction of the anterior crossbite at the maxillary right lateral incisor, and realignment of the midline. One year after retention, a satisfactory occlusion was maintained without recurrence of the anterior crossbite. The use of the open palatal window flap technique and button chain application is effective in correcting PDCs and achieving adequate tooth alignment within the dental arch. ©Penerbit Universiti Sains Malaysia.