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The Clinical Dilemma: An Impacted Tooth Risking Root Damage
A comprehensive specialist examination and 3D imaging by Orthodontist Claire O’Sullivan revealed a complex structural challenge:
- The Impacted Canine: The patient’s upper left adult canine (tooth 23) was severely impacted (trapped deep within the palate) and growing in an unpredictable direction.
- Root Resorption Risk: Advanced scans showed that the trapped canine was pressing directly against the root of the adjacent lateral incisor, threatening to permanently damage and destroy it via external root resorption.
- The Retained Baby Tooth: The baby canine (tooth 63) was still firmly in place but small and structurally mismatched with her adult teeth.
- Bite Discrepancy: The patient also presented with a localised crossbite and an uneven dental midline.
The Expert Multidisciplinary Strategy
Pulling a severely trapped canine to the surface can sometimes take over three years and carries a high risk of destroying the neighbouring tooth roots. To find the safest, most predictable outcome, Dr Claire O’Sullivan collaborated with implantologist Dr Kevin Gilmore.
Together, they designed and engineered a highly efficient, two-pronged approach: leave the impacted tooth safely monitored, align the bite, and cosmetically transform the naturally retained baby tooth to look exactly like a permanent adult canine.
Phase 1: Arch Expansion & Bite Correction (2021 – 2023)
- The Nance Appliance: We first fitted a specialised Nance appliance to expand the upper palate and guide the upper back molars into a stable, functional position.
- Fixed Metal Braces: High-precision fixed braces were bonded to coordinate both arches. Over a two-year period, our orthodontic therapists utilised specialised elastics to close spaces, eliminate the crossbite, and align the teeth into a flawless arch line. The braces were beautifully de-bonded in August 2023.
Phase 2: The Art of Cosmetic Composite Bonding
While the teeth were now perfectly straight, the small, naturally retained baby canine created an uneven gap and an asymmetrical smile line.
In September 2023, general dentist Dr Daniele Ryan stepped in to perform cosmetic edge bonding. To deliver the brightest aesthetic result, the patient first used whitening strips. Dr Ryan then meticulously hand-sculpted premium, tooth-coloured composite resin over the baby tooth, enlarging and reshaping it to match a natural adult canine perfectly. The sharp edges of her opposite canine were also gently contoured for absolute symmetry.
Phase 3: Immediate Protective Retention
Because composite bonding changes the physical shape of a tooth, traditional retainers will no longer fit. Immediately following the cosmetic appointment, Dr Claire O’Sullivan took new impressions and fitted a new, custom-moulded upper Essix retainer to firmly protect both the orthodontic alignment and the beautiful new bonding.
The Life-Changing Result
Sophie’s transformation was complete just as she was entering her senior school years. By combining advanced orthodontics with cosmetic artistry, our team completely bypassed the need for highly invasive, unpredictable surgeries. Sophie left our clinic with a healthy, stable bite and a symmetrical, radiant smile that she can finally display with absolute confidence in every photograph.
The Specialist Advantage: Complex cases involving impacted teeth require a seamless bridge between orthodontic movement and cosmetic restorations. At Dublin Orthodontist, our elite team of specialists coordinates your entire journey under one roof, delivering faster, safer, and more predictable results.
Discover Your Customised Smile Solution
If your child has a retained baby tooth, missing teeth, or a suspected trapped adult tooth, early specialist evaluation is essential. Our dedicated Dublin team is here to create a safe, beautiful, and tailored treatment programme for your family.
