Piezosurgery-Assisted Surgical Treatment in Impacted Canine
A 33-year-old man presented with the complaint of an absent lower canine on the left side. The patient had no other symptoms. The clinical examination revealed the absence of dental element 33. In light of the above, a computed tomography (CT) scan was requested, and transmigration of the left lower canine in the midline in the mentonian region, in the horizontal and vestibular position, was diagnosed.

Due to the unfavorable position of the dental element, orthodontic treatment was contraindicated, establishing surgical extraction as the preferred mode of treatment. The patient underwent surgery under local anesthesia with bilateral blocks of the lower alveolar nerve, complemented by a vestibular canine-to-canine infiltration terminal. During surgery, a horizontal incision was made 5 mm below the mucogingival line extending from canine to canine. The tissue was then detached, allowing partial visualization of the impacted tooth.

The surrounding tissue was then separated from the tooth and odonto section was carried out using a piezoelectric apparatus in order to minimize the trauma. After extracting the tooth, curettage and synthesis maneuver were performed in the internal musculature and in the superficial plane, both using an absorbable suture thread (Monocryl 5.0). At the end of the surgical procedure, the patient received counseling regarding postoperative care. Antibiotic was prescribed (Amoxicillin 500 mg every 8 hours for 7 days) with an anti-inflammatory (Meloxicam 7.5 mg every 12 hours) and analgesic (Dipyrone Sodium 500 mg every 6 hours for three days). The patient underwent 5 laser therapy sessions during the recovery period and returned after 7 days to remove the sutures. At this presentation, there was no complaint of pain or paresthesia and no evidence of infectious symptoms.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206859/