{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:54:58Z","timestamp":1781744098555,"version":"3.54.5"},"reference-count":40,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The incidence of maxillary canine impaction is estimated at approximately 1.7% of the population and is multifactorial in etiology. Several case reports suggest a potential relationship between canine impaction and root dilaceration of the adjacent premolar, indicating mechanical interference due to their proximity. In such cases, when avoiding tooth extractions is desired, it is crucial to consider specific clinical approaches to prevent contact with the dilacerated root during traction. This case report describes traction of an impacted maxillary canine in a female patient resulting from severe palatal root dilaceration of the adjacent first premolar. The canine was surgically exposed and traction was initiated after endodontic therapy and root sectioning of the affected premolar. After 24 months of orthodontic treatment, the results were satisfactory, with adequate gingival contour, 2 mm overjet and overbite, and a Class I relationship of canines and molars. No apparent root resorption was observed, and bone structure was preserved. A multidisciplinary approach is fundamental for the success of treatment in such cases, enabling achievement of a functionally and esthetically stable occlusion while avoiding tooth extractions.<\/jats:p>","DOI":"10.2319\/030925-196.1","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:31:09Z","timestamp":1757637069000},"page":"482-490","source":"Crossref","is-referenced-by-count":0,"title":["Orthodontic management of a patient with an impacted maxillary canine associated with severe palatal root dilaceration of the adjacent first premolar"],"prefix":"10.2319","volume":"96","author":[{"given":"Luana Karine Amaro","family":"Silva","sequence":"first","affiliation":[{"name":"PhD Student (Orthodontics), Department of Preventive and Community Dentistry. School of Dentistry. Rio de Janeiro State University, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Prado","sequence":"additional","affiliation":[{"name":"Professor, Department of Oral and Maxillofacial Surgery, State University of Rio de Janeiro, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Miranda","sequence":"additional","affiliation":[{"name":"Endodontic Specialist, Private Practice, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe de Assis Ribeiro","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Professor (Orthodontics), Department of Preventive and Community Dentistry. School of Dentistry. Rio de Janeiro State University, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhita Cristina Cunha","family":"Almeida","sequence":"additional","affiliation":[{"name":"Professor (Orthodontics), Department of Preventive and Community Dentistry. School of Dentistry. Rio de Janeiro State University, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i1945-7103-96-4-482-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"483","article-title":"Radiographic examination of ectopically erupting maxillary canines","volume":"91","author":"Ericson","year":"1987","unstructured":"Ericson S,\nKurol J. Radiographic examination of ectopically erupting maxillary canines. Am J Orthod Dentofacial Orthop. 1987;91:483\u2013492."},{"key":"i1945-7103-96-4-482-b02","series-title":"Oral Surg Oral Med Oral Pathol","first-page":"916","article-title":"A survey of 3,874 routine full-mouth radiographs","volume":"14","author":"Dachi","year":"1961","unstructured":"Dachi SF,\nHowell FV. A survey of 3,874 routine full-mouth radiographs. Oral Surg Oral Med Oral Pathol. 1961;14:916\u2013924."},{"key":"i1945-7103-96-4-482-b03","series-title":"Angle Orthod","first-page":"249","article-title":"The palatally displaced canine as a dental anomaly of genetic origin","volume":"64","author":"Peck","year":"1994","unstructured":"Peck S,\nPeck L,\nKataja M. The palatally displaced canine as a dental anomaly of genetic origin. Angle Orthod. 1994;64:249\u2013256."},{"key":"i1945-7103-96-4-482-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"159","article-title":"Impacted maxillary canines: a review","volume":"101","author":"Bishara","year":"1992","unstructured":"Bishara SE,\nOrtho D. Impacted maxillary canines: a review. Am J Orthod Dentofacial Orthop. 1992;101:159\u2013171."},{"key":"i1945-7103-96-4-482-b05","series-title":"J Orthod","first-page":"13","article-title":"Maxillary canine impaction; a final twist in the tale","volume":"31","author":"Chate","year":"2004","unstructured":"Chate RAC. Maxillary canine impaction; a final twist in the tale? J Orthod. 2004;31:13\u201314."},{"issue":"7","key":"i1945-7103-96-4-482-b06","series-title":"J Contemp Dent Pract","first-page":"108","article-title":"Case report: management of an impacted maxillary canine in association with a deviated palatal premolar root","volume":"9","author":"Turk","year":"2008","unstructured":"Turk T,\nElekdag-Turk S. Case report: management of an impacted maxillary canine in association with a deviated palatal premolar root. J Contemp Dent Pract. 2008;9(7):108\u2013114."},{"key":"i1945-7103-96-4-482-b07","series-title":"Eur J Orthod","first-page":"43","article-title":"Maxillary canine displacement; further twists in the tale","volume":"25","author":"Chate","year":"2003","unstructured":"Chate RAC. Maxillary canine displacement; further twists in the tale. Eur J Orthod. 2003;25:43\u201347."},{"key":"i1945-7103-96-4-482-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"167","article-title":"Root dilaceration in maxillary impacted canines and adjacent teeth: a retrospective analysis of the difference between buccal and palatal impaction","volume":"159","author":"Cao","year":"2021","unstructured":"Cao D,\nShao B,\nIzadikhah I, et al. Root dilaceration in maxillary impacted canines and adjacent teeth: a retrospective analysis of the difference between buccal and palatal impaction. Am J Orthod Dentofacial Orthop. 2021;159:167\u2013174."},{"key":"i1945-7103-96-4-482-b09","series-title":"Br J Orthod","first-page":"275","article-title":"Displacement of maxillary canines: a twist in the root","volume":"22","author":"Kerrigan","year":"1995","unstructured":"Kerrigan J,\nSandy JR. Displacement of maxillary canines: a twist in the root. Br J Orthod. 1995;22:275\u2013278."},{"key":"i1945-7103-96-4-482-b10","series-title":"J Clin Orthod","first-page":"709","article-title":"Orthodontic management of an impacted maxillary canine with an abnormal premolar root","volume":"34","author":"McNamara","year":"2000","unstructured":"McNamara TG,\nMcNamara CM. Orthodontic management of an impacted maxillary canine with an abnormal premolar root. J Clin Orthod. 2000;34:709\u2013711."},{"key":"i1945-7103-96-4-482-b11","series-title":"J Endod","first-page":"1730","article-title":"Endodontic surgery of a deviated premolar root in the surgical orthodontic management of an impacted maxillary canine","volume":"41","author":"Pedull\u00e0","year":"2015","unstructured":"Pedull\u00e0 E,\nValentino J,\nRapisarda S. Endodontic surgery of a deviated premolar root in the surgical orthodontic management of an impacted maxillary canine. J Endod. 2015;41:1730\u20131734."},{"key":"i1945-7103-96-4-482-b12","series-title":"Dent Traumatol","first-page":"427","article-title":"Dilaceration of maxillary central incisor: a literature review","volume":"26","author":"Topouzelis","year":"2010","unstructured":"Topouzelis N,\nTsaousoglou P,\nPisoka V,\nZouloumis L. Dilaceration of maxillary central incisor: a literature review. Dent Traumatol. 2010;26:427\u2013433."},{"key":"i1945-7103-96-4-482-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"692","article-title":"Forced eruption of impacted maxillary central incisors with severely dilacerated roots","volume":"150","author":"Chang","year":"2016","unstructured":"Chang N-Y,\nPark JH,\nKim S-C, et al. Forced eruption of impacted maxillary central incisors with severely dilacerated roots. Am J Orthod Dentofacial Orthop. 2016;150:692\u2013702."},{"key":"i1945-7103-96-4-482-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"514","article-title":"Concomitant dilaceration, transposition, and intraosseous migration: Report of a patient treated with maxillary canine-central incisor substitution","volume":"146","author":"Campbell","year":"2014","unstructured":"Campbell CM,\nDiBiase A,\nFleming PS. Concomitant dilaceration, transposition, and intraosseous migration: Report of a patient treated with maxillary canine-central incisor substitution. Am J Orthod Dentofacial Orthop. 2014;146:514\u2013521."},{"key":"i1945-7103-96-4-482-b15","series-title":"Oral Radiol","first-page":"27","article-title":"A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population","volume":"29","author":"Bodrumlu","year":"2013","unstructured":"Bodrumlu E,\nGunduz K,\nAvsever H,\nCicek E. A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population. Oral Radiol. 2013;29:27\u201332."},{"key":"i1945-7103-96-4-482-b16","series-title":"Anomalies of the Developing Dentition","author":"Soxman","year":"2019","unstructured":"Soxman JA,\nWunsch PB,\nHaberland CM. Anomalies of the Developing Dentition. Springer International Publishing; 2019."},{"key":"i1945-7103-96-4-482-b17","series-title":"Dental Press J Orthod","first-page":"74","article-title":"Orthodontic traction of impacted canines: concepts and clinical application","volume":"24","author":"Cruz","year":"2019","unstructured":"Cruz RM. Orthodontic traction of impacted canines: concepts and clinical application. Dental Press J Orthod. 2019;24:74\u201387."},{"key":"i1945-7103-96-4-482-b18","series-title":"J Clin Periodontol","first-page":"828","article-title":"Analysis of etiologic factors and periodontal conditions involved with 309 abfractions","volume":"30","author":"Miller","year":"2003","unstructured":"Miller N,\nPenaud J,\nAmbrosini P,\nBisson-Boutelliez C,\nBrian\u00e7on S. Analysis of etiologic factors and periodontal conditions involved with 309 abfractions. J Clin Periodontol. 2003;30:828\u2013832."},{"issue":"1","key":"i1945-7103-96-4-482-b19","series-title":"Dental Press J Orthod","first-page":"e22spe1","article-title":"Agenesis of maxillary lateral incisors: diagnosis and treatment options","volume":"27","author":"Schroeder","year":"2022","unstructured":"Schroeder DK,\nSchroeder MA,\nVasconcelos V. Agenesis of maxillary lateral incisors: diagnosis and treatment options. Dental Press J Orthod. 2022;27(1):e22spe1."},{"key":"i1945-7103-96-4-482-b20","series-title":"Eur J Orthod","first-page":"99","article-title":"Aspects on osseointegrated implants inserted in growing jaws. a biometric and radiographic study in the young pig","volume":"14","author":"Thilander","year":"1992","unstructured":"Thilander B,\nOdman J,\nGrondahl K,\nLekholm U. Aspects on osseointegrated implants inserted in growing jaws. a biometric and radiographic study in the young pig. Eur J Orthod. 1992;14:99\u2013109."},{"key":"i1945-7103-96-4-482-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"483","article-title":"Radiographic examination of ectopically erupting maxillary canines","volume":"91","author":"Ericson","year":"1987","unstructured":"Ericson S,\nKurol J. Radiographic examination of ectopically erupting maxillary canines. Am J Orthod Dentofacial Orthop. 1987;91:483\u2013492."},{"key":"i1945-7103-96-4-482-b02","series-title":"Oral Surg Oral Med Oral Pathol","first-page":"916","article-title":"A survey of 3,874 routine full-mouth radiographs","volume":"14","author":"Dachi","year":"1961","unstructured":"Dachi SF,\nHowell FV. A survey of 3,874 routine full-mouth radiographs. Oral Surg Oral Med Oral Pathol. 1961;14:916\u2013924."},{"key":"i1945-7103-96-4-482-b03","series-title":"Angle Orthod","first-page":"249","article-title":"The palatally displaced canine as a dental anomaly of genetic origin","volume":"64","author":"Peck","year":"1994","unstructured":"Peck S,\nPeck L,\nKataja M. The palatally displaced canine as a dental anomaly of genetic origin. Angle Orthod. 1994;64:249\u2013256."},{"key":"i1945-7103-96-4-482-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"159","article-title":"Impacted maxillary canines: a review","volume":"101","author":"Bishara","year":"1992","unstructured":"Bishara SE,\nOrtho D. Impacted maxillary canines: a review. Am J Orthod Dentofacial Orthop. 1992;101:159\u2013171."},{"key":"i1945-7103-96-4-482-b05","series-title":"J Orthod","first-page":"13","article-title":"Maxillary canine impaction; a final twist in the tale","volume":"31","author":"Chate","year":"2004","unstructured":"Chate RAC. Maxillary canine impaction; a final twist in the tale? J Orthod. 2004;31:13\u201314."},{"issue":"7","key":"i1945-7103-96-4-482-b06","series-title":"J Contemp Dent Pract","first-page":"108","article-title":"Case report: management of an impacted maxillary canine in association with a deviated palatal premolar root","volume":"9","author":"Turk","year":"2008","unstructured":"Turk T,\nElekdag-Turk S. Case report: management of an impacted maxillary canine in association with a deviated palatal premolar root. J Contemp Dent Pract. 2008;9(7):108\u2013114."},{"key":"i1945-7103-96-4-482-b07","series-title":"Eur J Orthod","first-page":"43","article-title":"Maxillary canine displacement; further twists in the tale","volume":"25","author":"Chate","year":"2003","unstructured":"Chate RAC. Maxillary canine displacement; further twists in the tale. Eur J Orthod. 2003;25:43\u201347."},{"key":"i1945-7103-96-4-482-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"167","article-title":"Root dilaceration in maxillary impacted canines and adjacent teeth: a retrospective analysis of the difference between buccal and palatal impaction","volume":"159","author":"Cao","year":"2021","unstructured":"Cao D,\nShao B,\nIzadikhah I, et al. Root dilaceration in maxillary impacted canines and adjacent teeth: a retrospective analysis of the difference between buccal and palatal impaction. Am J Orthod Dentofacial Orthop. 2021;159:167\u2013174."},{"key":"i1945-7103-96-4-482-b09","series-title":"Br J Orthod","first-page":"275","article-title":"Displacement of maxillary canines: a twist in the root","volume":"22","author":"Kerrigan","year":"1995","unstructured":"Kerrigan J,\nSandy JR. Displacement of maxillary canines: a twist in the root. Br J Orthod. 1995;22:275\u2013278."},{"key":"i1945-7103-96-4-482-b10","series-title":"J Clin Orthod","first-page":"709","article-title":"Orthodontic management of an impacted maxillary canine with an abnormal premolar root","volume":"34","author":"McNamara","year":"2000","unstructured":"McNamara TG,\nMcNamara CM. Orthodontic management of an impacted maxillary canine with an abnormal premolar root. J Clin Orthod. 2000;34:709\u2013711."},{"key":"i1945-7103-96-4-482-b11","series-title":"J Endod","first-page":"1730","article-title":"Endodontic surgery of a deviated premolar root in the surgical orthodontic management of an impacted maxillary canine","volume":"41","author":"Pedull\u00e0","year":"2015","unstructured":"Pedull\u00e0 E,\nValentino J,\nRapisarda S. Endodontic surgery of a deviated premolar root in the surgical orthodontic management of an impacted maxillary canine. J Endod. 2015;41:1730\u20131734."},{"key":"i1945-7103-96-4-482-b12","series-title":"Dent Traumatol","first-page":"427","article-title":"Dilaceration of maxillary central incisor: a literature review","volume":"26","author":"Topouzelis","year":"2010","unstructured":"Topouzelis N,\nTsaousoglou P,\nPisoka V,\nZouloumis L. Dilaceration of maxillary central incisor: a literature review. Dent Traumatol. 2010;26:427\u2013433."},{"key":"i1945-7103-96-4-482-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"692","article-title":"Forced eruption of impacted maxillary central incisors with severely dilacerated roots","volume":"150","author":"Chang","year":"2016","unstructured":"Chang N-Y,\nPark JH,\nKim S-C, et al. Forced eruption of impacted maxillary central incisors with severely dilacerated roots. Am J Orthod Dentofacial Orthop. 2016;150:692\u2013702."},{"key":"i1945-7103-96-4-482-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"514","article-title":"Concomitant dilaceration, transposition, and intraosseous migration: Report of a patient treated with maxillary canine-central incisor substitution","volume":"146","author":"Campbell","year":"2014","unstructured":"Campbell CM,\nDiBiase A,\nFleming PS. Concomitant dilaceration, transposition, and intraosseous migration: Report of a patient treated with maxillary canine-central incisor substitution. Am J Orthod Dentofacial Orthop. 2014;146:514\u2013521."},{"key":"i1945-7103-96-4-482-b15","series-title":"Oral Radiol","first-page":"27","article-title":"A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population","volume":"29","author":"Bodrumlu","year":"2013","unstructured":"Bodrumlu E,\nGunduz K,\nAvsever H,\nCicek E. A retrospective study of the prevalence and characteristics of root dilaceration in a sample of the Turkish population. Oral Radiol. 2013;29:27\u201332."},{"key":"i1945-7103-96-4-482-b16","series-title":"Anomalies of the Developing Dentition","author":"Soxman","year":"2019","unstructured":"Soxman JA,\nWunsch PB,\nHaberland CM. Anomalies of the Developing Dentition. Springer International Publishing; 2019."},{"key":"i1945-7103-96-4-482-b17","series-title":"Dental Press J Orthod","first-page":"74","article-title":"Orthodontic traction of impacted canines: concepts and clinical application","volume":"24","author":"Cruz","year":"2019","unstructured":"Cruz RM. Orthodontic traction of impacted canines: concepts and clinical application. Dental Press J Orthod. 2019;24:74\u201387."},{"key":"i1945-7103-96-4-482-b18","series-title":"J Clin Periodontol","first-page":"828","article-title":"Analysis of etiologic factors and periodontal conditions involved with 309 abfractions","volume":"30","author":"Miller","year":"2003","unstructured":"Miller N,\nPenaud J,\nAmbrosini P,\nBisson-Boutelliez C,\nBrian\u00e7on S. Analysis of etiologic factors and periodontal conditions involved with 309 abfractions. J Clin Periodontol. 2003;30:828\u2013832."},{"issue":"1","key":"i1945-7103-96-4-482-b19","series-title":"Dental Press J Orthod","first-page":"e22spe1","article-title":"Agenesis of maxillary lateral incisors: diagnosis and treatment options","volume":"27","author":"Schroeder","year":"2022","unstructured":"Schroeder DK,\nSchroeder MA,\nVasconcelos V. Agenesis of maxillary lateral incisors: diagnosis and treatment options. Dental Press J Orthod. 2022;27(1):e22spe1."},{"key":"i1945-7103-96-4-482-b20","series-title":"Eur J Orthod","first-page":"99","article-title":"Aspects on osseointegrated implants inserted in growing jaws. a biometric and radiographic study in the young pig","volume":"14","author":"Thilander","year":"1992","unstructured":"Thilander B,\nOdman J,\nGrondahl K,\nLekholm U. Aspects on osseointegrated implants inserted in growing jaws. a biometric and radiographic study in the young pig. Eur J Orthod. 1992;14:99\u2013109."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/4\/article-p482.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/4\/article-p482.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/4\/article-p482.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:31:03Z","timestamp":1781742663000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/4\/article-p482.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":40,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2319\/030925-196.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}