Open Access ISSN: 2165-7920 Clinical Case Reports Case Report Volume 11:3, 2021 *Address for Correspondence: Chakraborty P, Department of Orthodontics, Private Practitioner, Consultant Orthodontist, Lucknow, India, E-mail: parijatchak@gmail.com Copyright: © 2021 Chakraborty P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Received 25 January 2021; Accepted 01 March 2021; Published 08 March 2021 Alignment of Buccally Erupted Canine Using HANT Wire Parijat Chakraborty 1 *, Kamlesh Singh 2 , Ragni Tandon 2 , Richa Dhingra 2 and Pranshu Mathur 2 ¹Department of Orthodontics, Private Practitioner, Consultant Orthodontist, Lucknow, India ²Department of Orthodontics and Dentofacial Orthopedics, Saraswati Dental College, Lucknow, India Abstract Ectopic teeth develop when displaced from their normal position. Any permanent tooth can be ectopic, and the cause may be both genetic and environmental. Orthodontic treatment is justifiable for aesthetic reasons. Subsequently a careful diagnosis along with a proper treatment plan for ectopically erupting permanent maxillary canines requires timely management by the orthodontist. The purpose of this case report is to illustrate an approach involving management using HANT wire. Keywords: HANT wire • Orthodontic • Ectopic teeth Introduction The failure of permanent teeth to erupt into their normal position in the dental arches is usually due to a discrepancy between tooth size and over- all arch length [1]. The prevalence of permanent maxillary canine impaction or ectopic eruption in the general population is approximately 1-2% in which palatally displaced canine is twice as much of the buccally placed canine. But, ironically buccally placed canines are seen more in clinical practice [2] (Figure 1). Orthodontic tooth movement of buccally placed canines is usually difficult as it is always related with problems of severe crowding, midline deviation, involvement of long root movement along with its angulations, risk of damage to adjacent tooth structures and risk of gingival recession [3]. For the management of ectopic canines, the approaches have been classified accordingly: use of sliding mechanisms and other using loop mechanics. Possible means for creating for space the canine is interproximal reduction, arch expansion, distal movement of molars, extraction, or any type of combination of the above. Alignment of malpositioned teeth is generally treated using multi-looped Stainless Steel (SS) wires, coaxial wires, Nickel titanium (NiTi) wires, or Heat Activated Nickel Titanium (HANT) wires. However, when ectopically erupted canines are aligned with NiTi wires, due to their bulky root structure, there is a risk of round tripping of adjacent teeth. This creates a load on the anchorage leading to anchor loss and prolongs the treatment duration [4,5]. The upper canines’ significance to dental esthetics and functional occlusion makes the decision a very serious one. The purpose of this report is to illustrate an approach involving orthodontic management using HANT wire. The case was treated through an orthodontic nonextraction fixed appliance mechanotherapy for successful alignment of buccally ectopic upper right canine. Case Report The patient was a North Indian female who presented at the age of 12 years and 4 months to the Department of Orthodontics with a chief complaint of malposed canine. On examination, the individual had Class I malocclusion on a Class II skeletal base. The upper incisors were normal, with a 2 mm space in between the maxillary central incisors. The overjet was normal (3 mm), and the overbite was 50% (4 mm). There was retained deciduous canine present in the 1 st quadrant. The permanent right maxillary canine was highly placed buccally between the 1 st and 2 nd maxillary premolars (Figure 2). The Orth Pantograph (OPG) showed that all permanent teeth roots appeared to be of normal size, morphology, and at a normal developmental stage along with a retained deciduous canine in the first quadrant. The right permanent maxillary canine was positioned in between 1 st and 2 nd premolar along with its root highly positioned. The root of right 1 st premolar was a bit short and mesially titled towards the lateral incisor root as appreciated in the radiograph (Figure 3). The cephalometric analysis showed ANB value of 6°C, which suggests that the patient had a Class II skeletal pattern. This was supported by the Wits analysis (+3 mm). The ratio of lower to total anterior face height was average (67%). Figure 1. Etiology of ectopic/malposed canine. Figure 2. Pre-treatment intraoral photographs.