Orthodontic Microscrew for Ectopic Maxillary Canine Extraction in an Adolescent: A Case Report.

Extraction of a permanent maxillary canine in a skeletally immature patient creates a rehabilitative interval during which definitive implant therapy is contraindicated and conventional alternatives have well-known limitations. This case report describes the use of a titanium orthodontic microscrew as a transitional prosthetic support in this clinical situation. A 13-year-old female patient was referred with an impacted right maxillary canine in a severely ectopic position adjacent to the floor of the maxillary sinus. Orthodontic traction was considered unfeasible based on the tooth position, axial inclination, and the presence of root dilaceration in the adjacent first premolar. Following extraction and orthodontic recovery of the edentulous space, cone-beam computed tomography (CBCT)-based digital planning and a custom surgical guide were used to place a 1.36 × 12 mm titanium microscrew vertically in the canine site. A provisional polymethyl methacrylate crown was designed by computer-aided design and computer-aided manufacturing (CAD/CAM) and fabricated by 3D printing, then delivered under a non-functional immediate loading protocol. After 12 months of clinical and radiographic follow-up, the soft tissues surrounding the microscrew were healthy, and no biologic or mechanical complications were recorded. A control CBCT at 12 months showed no apparent change in the alveolar contour at the treated site.