Computer Guided Implant placement through impacted Canine and immediate provisionalization Nazario Russo 1,3 , Giacomo Coppola 1,3 , Davide Montisci 1,3 , Leonardo Palazzo 2 , Amedeo Lenzo 1,3 , Andrea Mascolo 3 ,Massimiliano Ciaravolo 1,3 1 Department of Biomedical and Dental Sciences, University of Cagliari, Cagliari, 09121, Italy 2 Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, 06123, Italy 3 European Institute for Medical Studies (EIMS) - H.E.I., Graduate School, Malta Abstract Introduction : The aim of this study was to evaluate an unconventional protocol regarding implants insertion through impacted canines, as to avoid invasive surgical extraction. Materials and Methods: This study was conducted on 1 patient, selected from the waiting list for dental implants at the University of Cagliari. To avoid invasive surgical removal of the impacted tooth, a dental implant (Ø 3.75 x 12 mm, Leone s.p.a., Firenze, Italy) was placed through the impacted tooth with a computer guided protocol and then immediate loaded. Results: The implant was clinically stable; a 4-year follow up did not show any unusual feature at the root ‐implant interface. Conclusions: This study suggests that implant insertion through an impacted canine does not interfere with implant integration and may represent an alternative solution to avoid surgery extraction; more studies are needed for this procedure to be considered suitable for a possible clinical option. Keywords: Oral Surgical Procedures; Osseointegration; Impacted tooth; Orthodontics; Dental implant; Single tooth; Tooth root; Tooth crown; Dental prosthesis. 1. Introduction The aim of this study was to to evaluate an unconventional protocol implants insertion through the impacted canine when this was found on the trajectory of a planned implant. Instead of extracting the impacted canine, treat the voluminous bone defect with regeneration techniques and wait for healing, an implant was placed through the impacted canine. Impaction is defined as failure in tooth eruption, which can be the result of obstruction in the eruption path or inappropriate tooth position [1]. After mandibular third molars, permanent maxillary canine are the second most frequently impacted teeth. The incidence of their impaction is 1-2% in general population but the frequencies vary from country to country [2]. Factors affecting the prevalence of impaction include the age range of the target sample, radiographic features of tooth development and the timing of dental eruption [3], as regards frequency, there are many studies with different data, in the Italian population a prevalence of 2.4% is indicated [4]. The etiology of canine impaction may be related to general factors, such as inheritance, endocrine deficiencies, febrile diseases, and irradiation. Regarding local factors, the causes include tooth size-arch length discrepancy, prolonged retention, premature loss of primary canines, abnormal position of the tooth germ, presence of alveolar cleft, agenesis, ankylosis, supernumerary teeth, deleterious oral habits, trauma, disruption of the root structure, iatrogenic and idiopathic causes, and ectopic path of eruption [5]. Several radiographs are available for examination of impacted teeth. Panoramic radiographs, are often the first prescribed radiographs because they can provide information about all the teeth in upper and lower jaw and the surrounding structures. The panoramic radiograph is used as the basic method in epidemic research due to its economic and practical characteristics [6,7]. There are several known treatment options for impacted canines , surgical exposure and orthodontic traction is the preferred approach in compliant, motivated patients, with good dental health, where interceptive measures are inappropriate [8]. If orthodontic treatment are not feasible because of factors such as not good position of canine, severity of impaction and age of the patient, or when the patient is not willing to encounter conventional treatment options because of treatment duration, morbidity, and costs, single implant treatment should be considered, IJCSI International Journal of Computer Science Issues, Volume 17, Issue 6, November 2020 ISSN (Print): 1694-0814 | ISSN (Online): 1694-0784 www.IJCSI.org https://doi.org/10.5281/zenodo.4431048 9 2020 International Journal of Computer Science Issues