It is not
uncommon when permanent teeth begin to erupt that one or more of them do
not do so. This most commonly happens with the canines (eye teeth). The
treatment is usually uncomplicated - just extract the deciduous tooth
(baby tooth), and surgically expose the crown of the impacted tooth so an
orthodontic chain can be bonded to it. The tooth can then be moved into
proper position orthodontically.In this case, the canine (eye tooth)
was impacted, and then brought into position with orthodontics.
Unfortunately, there was periodontal disease present, which was not
recognized or treated. As a result, bone did not come down with the tooth
as it was moved into position. This resulted in a severe bony defect (see
X-ray).
The two involved teeth were extracted and a bone graft placed. After
healing, the ridge appeared very irregular and required a soft tissue
graft.
In the final photo, the implants are restored. Note the healthy pink
color of the gums.
