If an impacted maxillary canine needs to be brought into position, you will find the following technique to be a quick, easy, painless method to apply an eruptive force to the impacted tooth.
Using an explorer shank as a core, twist loops into .012 or .014 ligature wire 1mm apart. Attach this wire to a bracket (preferably to a metal bracket) and bond the bracket to the impacted canine. Insert an .045 or .052 overlay archwire into the molar facebow tubes, and tie it to the anterior teeth for stabilization. Elastic thread is then passed through one of the loops and around the heavy archwire. This eliminates intrusion of bicuspids and incisors, while attempting to move the canine into position. The force is distributed throughout the arch. As the tooth extrudes, cut off the loops and retie.
Midline Correction
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Rather than using Class II and Class III elastics to eliminate midline discrepancies, a straight pull headgear or Hickham headgear can be used in order to make the correction. The photo demonstrates the correction of a midline problem where the maxillary midline was to the right and mandibular midline was to the left. This technique eliminates the undesirable canting of the occlusal plane which occurs with the use of elastics.
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