Orthodontic management of bilateral ectopic and transposed canines using miniimplant assisted rapid palatal expander and an implant-borne distalizer

Mini-implant assisted rapid palatal expanders for treating transverse maxillomandibular disparity, and
implant-borne distalization techniques for correcting Class II malocclusion have gained increasing popularity
in recent years. This case report presents a girl aged 13 years, 6 months with impacted maxillary canines
that were transposed with crowns mesial to the lateral incisors, Class II molar relationship, an open bite,
and a narrow maxillary arch. The treatment plan involved a combination of mini-implants, assisted rapid
palatal expander, and distalization with a Beneslider to lengthen the maxillary arch sufficiently to bring the
impacted canines into occlusion using calculated and very precise sectional mechanics. After 32 months of
active treatment, favorable crown inclinations and angulations were achieved with Class I canine and molar
relationship bilaterally, after which the brackets were removed. The result was retained using fixed lingual
retainers on the maxillary and mandibular arches and removable Essix maxillary and mandibular retainers.
Force-driven treatment mechanics are the most effective and efficient way to direct treatment procedures
for significantly displaced ectopic teeth.