Aspectos periodontais e ortodônticos na exposição de caninos superiores inclusos

Os caninos superiores apresentam o periodo e o trajeto mais longo de desenvolvimento, desde o ponto de formacao ate o seu destino final, na linha de oclusao. A erupcao ectopica e a inclusao do canino superior permanente sao problemas clinicos frequentes. Seu diagnostico e baseado no exame clinico e radiografico, incluindo radiografias panorâmicas, oclusais, periapicais, telerradiografias de perfil e tomografias computadorizadas. O diagnostico e o tratamento desse problema, geralmente, requerem pericia e cooperacao do clinico geral, odontopediatra, cirurgiao bucomaxilofacial, periodontista, assim como do ortodontista. O tratamento do canino superior incluso requer a interacao cirurgica e ortodontica. Dois metodos de exposicao cirurgica sao utilizados: exposicao aberta, onde o acessorio e instalado depois que o canino irrompe livremente, e exposicao fechada com a fixacao de um acessorio, seguida pela tracao com forcas ortodonticas suaves. Os caninos superiores inclusos requerem minimos efeitos no periodonto e efeitos colaterais minimos aos dentes adjacentes e aos tecidos gengivais. O tratamento ortodontico de dentes inclusos necessita de controle adicional de placa bacteriana pelo profissional e pelo paciente.(AU) The maxillary canines presents the longest development period from its origin and to final destination in the occlusion line. The diagnosis and treatment of this problem usually requires the expertise and cooperation of the general practitioner, the pediatric dentist, the oral surgeon and the periodontist, as well as the orthodontist. The ectopic eruption and impaction of maxillary permanent canines is a clinical problem frequently encountered and the diagnosis of impaction is based on both clinical and radiographic examinations as panoramic, occlusal, periapical, lateral headfilm and the computed tomography. The impacted maxillary canine is a difficult orthodontic problem, often requiring surgical and orthodontic cooperation. Two methods of surgical exposure are commonly used: open exposure, where traction is placed after the canine erupts freely, and closed exposure with placement of an auxiliary attachment, followed by traction with orthodontic forces. The management of impacted maxillary canines requires minimal effects on the periodontium and minimal consequences to the adjacent teeth and gingival tissues. Orthodontic treatment of impacted teeth might require additional professional and personal plaque control measures.(AU)