Disinclusion of palatally impacted canines with surgical and photobiomodulating action of a Diode Laser: Case series

Background: The permanent maxillary canine is the most impacted tooth after third molars. There are many possible surgical techniques to approach impacted canines. The literature reports that high-intensity laser therapies (HILTs) can be used for opercolectomy of an impacted tooth. The aim of this study is to propose a new orthodontic-surgical approach using a laser for the disinclusion of palatally impacted canines. Methods: Nine patients presented maxillary primary canine persistence in the dental arch. Orthopanoramic X-ray and cone beam computed tomography (CBCT) showed the impaction of permanent maxillary canines. Surgical exposure was performed using a diode laser (Raffaello, DMT, Lissone, Italy, 980 nm + 645 nm). No orthodontic devices were applied for impacted tooth traction. Canine movement was monitored at 1, 8, 16 weeks post-surgery with photos and a CS3500 intraoral scanner (Carestream Dental, Atlanta USA) to evaluate their autonomous eruption. Results: No complications were observed. In all the cases, complete disimpaction of the treated canines was obtained in only four months. Conclusions: Impacted canine exposure with a diode laser has many advantages if compared with traditional surgery. The pre-orthodontic exposure and autonomous eruption of impacted canines provided simplified and predictable outcomes. The absence of traction and the reduced time for orthodontic treatment increased compliance during the orthodontic alignment.