Assoc. Prof. Dr. Apostolos I. Tsolakis
Apostolos I. Tsolakis earned his DDS Degree from the University of Thessaloniki,
Greece and received his Master’s Degree of Science in Dentistry with specialty
certification in Orthodontics at Case Western Reserve University, USA. Dr. Tsolakis
holds a PhD Degree from Athens University, Greece. Currently he is Assοciate
Professor of Orthodontics at the University of Athens, Greece. He also serves as
Adjunct Associate Professor of Orthodontics at Case Western Reserve University,
Cleveland, Ohio, USA. He has worked through academics on a variety of research
projects, including the normal and abnormal growth and development of the mandible
and maxilla, biologic mechanisms of tooth movement in normal and osteoporotic rats,
class III orthodontic problems and impacted teeth with selected publications in these
fields. He has published extensively in international and Greek journals and he has
contributed to several book chapters with one of his noteworthy contributions to
Enlow’s and Hans’s book “Essentials of Facial Growth”. He has lectured extensively
in Universities and Professional Organizations in Europe and United States. He is the
editor of the journal “European Journal of Dental Science”. Also he maintains a
clinical orthodontic practice at his private offices in Athens and Larissa Greece.
”IMPACTION OF MAXILLARY CANINES: DIAGNOSIS, PREVENTION
AND TREATMENT PROTOCOLS ”
Apostolos I. Tsolakis, Associate Professor of Orthodontics
National and Kapodistrian University of Athens , Greece.
Maxillary canines are the second more frequent impacted teeth, after the third molars
presenting a prevalence of impaction ranging from 1% to 3%.
A radiographic evaluation is always necessary in order to confirm the canine
impaction. The sensitivity of CBCT compared to the conventional x-rays is much
higher allowing more precise diagnosis of the location, the detection of possible root
resorption in adjacent lateral and /or central incisors due to canine impaction, as well
as treatment decisions.
Prevention is primarily followed during mixed dentition period, including expansion
and distal movement of the dental arch. Also extraction of the primary canines in
selective cases may be helpful. Whenever prevention strategy of impacted maxillary
canines fails, the conventional treatment consists of combined surgical and
orthodontic traction approach.
There is a debate among clinicians whether the open or the closed surgical exposure is
the favorable treatment of choice for palatally impacted canines. There is some
evidence that there is no difference between the two techniques in terms of
periodontal health, and that the open exposure technique constitutes a shorter surgical
Following the surgical exposure, an orthodontic button is bonded on the crown and a
wire chain is fixed on the button. Orthodontic traction is applied to the impacted
canine and the force is directed according to the site and direction of impaction, taken
care of possible resorptions of the adjacent teeth. Many biomechanical strategies have
been proposed with the aim to avoid possible side effects. Whenever the impacted
canine erupts in the alveolar ridge any rotations and /or torque movements are
considered. A number of clinical cases and various treatment protocols are presented.