Orthodontic procedures are generally performed in young patients during or just after eruption of their permanent teeth. We most commonly perform orthodontic treatment to correct the position of traumatically positioned canine teeth. A masal chain appliance is most often utilised to treat mesioverted or ‘lanced’ maxillary canine teeth or as part of management of linguvoverted canine teeth where the maxillary diastema (space between the maxillary third incisor and canine teeth) is too narrow to accommodate the mandibular canine tooth and needs to be widened.
Mesioverted or ‘lanced’ canine teeth often require correction as their abnormal positioning may impact bite function and mouth closure or lip position. This condition where the maxillary canine tooth is pointing forward will often contribute the linguoversion or ‘base narrow’ mandibular canine teeth. This is due to the position of the maxillary canine resulting in a narrowed gap for the mandibular canine tooth to erupt into this reduced space impedes the lower canine from assuming its normal position between these upper teeth. Consequently, the mandibular canines may be forced into a traumatic position where they contact the roof of the mouth. Potential problems include painful contact with the hard palate, tooth-on-tooth wear, and trauma to the lip.
Not every patient with a malocclusion is a candidate for orthodontics. If your pet is a candidate, these treatments offers an excellent long-term solution. They have less requirement for extended follow-up than other treatments such as a crown height reduction and vital pulpotomy and is less invasive than extractions. Another advantage is that this type of procedure does not alter the size or shape of the teeth, maintaining full form and function for your pet. When treatment is successful, your pup is back to normal.
Orthodontic appliances used for treatment of mesioverted maxillary canine teeth or to widen the maxillary diastema are designed to place a tipping force to the malpositioned maxillary canine tooth to widen the diastema (space) between the maxillary third incisor and canine tooth. The most common appliance is created chairside directly in the patients mouth and is referred to as a masal chain.
The orthodontic technique involves placement of orthodontic brackets on the maxillary fourth premolar and first molar teeth, these are then wired together to form a single anchor unit. A wire hook or similar is also placed on the maxillary canine tooth. An elastic chain is placed between the maxillary canine and the anchoring teeth to place a distal tipping force on the maxillary canine tooth. Treatment generally takes between 4-6 weeks and regular visits are required during this time. The elastic chain may need to be tightened or replaced during the treatment period, this can generally be done without sedation of the patient.
Over a period of weeks the maxillary canine teeth are tipped distally (caudally) into a more correct position. Once the teeth are in a suitable position the appliance is removed during a short anaesthetic. In many cases a second orthodontic procedure is required to then tip the mandibular canines into position if they are in a base narrow position (see inclined plane/crown extensions).
In almost all cases, a retainer is not required unlike people that have had braces. This is due to the canine teeth locking into their correct position (canine interlock). This is a natural retainer.
For the majority of patients we perform this procedure on, treatment is uneventful. The appliance is not indestructible, and care must be taken to avoid any rough mouth play whilst it is in place. This avoids the need for any repairs and associated additional cost.
When a patient has an orthodontic appliance in place, they are more prone to plaque build-up. A higher level of homecare during the weeks the appliance is in place is recommended. This may involve gently brushing around the appliance and using a gel/rinse to reduce the number of plaque bacteria in the mouth that can make things a little smelly!
Orthodontic treatment can be an excellent choice for the right patient. Determining if this treatment is right for you and your pet is something that we can do following a thorough assessment and discussion of all available treatment options.