Impacted Maxillary Canine: Proper Protocol?

please post photos and radiographs, so that a definitive response can be produced! Cheers

I don't mean to sound negative, but this sounds like a case for an oral surgeon and a dentist with a lot of experience in restoring implants. Important factors are: 1. Patient's age 2. Source of sinus tract 3. The idea of a canine cantilever sounds scary, usually it's the other way around (lateral incisor cantilevered off the canine.) Restoratively this case needs planning, wax up, etc...

Dear Dr K. The buried canine should be removed first before any implant placement. The canine is in the way and it can also give problems after the implants are in place and can happen soon or years down the road. Either scenario is not pleasant. If you bet on it not giving problems, the nagging possibility at the back of your mind may reduce your lifespan by a few hours to a few years. You can place the implants immediately after removal of the canine or wait for healing first before placement.

Always, but always remove impacted teeth, and augment the sockets prior to implant placement, Wait 6 months before second surgery for the implants

I agree 100% with the post of sb oms. Explore your prosthetic treatment options with the aid of a diagnostic waxup and then consult a good oral surgeon for your surgical component. Remember that a cantilevered canine is not a good solution, and even worse if you wer thinking of doing it off of a lateral. Without looking at any records we are just guessing, but I get the feeling that the impacted canine will need to come out. Good luck!

Cantilevering one of the most powerful tooth to one of the weakest, is a prescription for a disaster!The lateral will be overwhelmed by the sheer load imposed on the canine, not to mention by its functional position. Man will do what comes naturally- use that canine to tear up food. The prosthesis will not stand a chance, especially with the male gender. Bear in mind, you're dealing with an implant which is relatively weaker than the natural dentition. Even with natural teeth, this arrangement is a big NO! NO! To complicate this further, the impacted canine is going to vacate a considerable amount of space upon its removal, in a highly critical area, the esthetic zone. It would be a wise decision to earn more experience before you embark on a venture as challenging as this. REFER...

Too many loose ends on this. Refer to your oral surgeon of choice ASAP!

first create a sound bone. Remove the canine and sinustracts and watch the healing. Then plan your treatment with a wax-up and placing the implants after you rebuild the bone where it is required. The canine and first molars are the key positions for implant placements. I don't see the purpose of doing the wax-up and planing before you have created a sound and healthy environment to lace your implants in. Make it simple to do these things one at the time. If you are good at sinus-surgery you can try to remove it after lifting the membrane.

Let's be honest here! If you were having surgery on a very COMPLICATED AREA and your doc had to ask in a forum, "what should I do?" Would you want to have that procedure done by that doc? Remember when you do what is RIGHT for the patient and they know it, they are patients for life. Point being do what is right and refer patients as needed.