Combination of surgical exposure and fixed orthodontic appliance in bilateral impacted canine

Objective: This case report is to describe the management of bilateral impacted canine due to the persistence of deciduous teeth with surgical procedures and retraction with orthodontic tools. 
Methods: Orthodontic treatment used a Straight Wire system with a 0.22 bracket slot. It began with the use of Niti 0.14 for the correction of anterior teeth crowding. Teeth 53 and 63 extraction were performed and continued with Niti 0.18 wire to correct crowding and obtain sufficient eruption spaces for teeth 13 and 23. The surgery used an open window procedure with a full-thickness triangular flap to open the canine crown, bracket placement, and canine retraction using an elastomeric chain. 
Results: Within five months, the crowding was corrected, and enough space was obtained for the canine eruption, and within three months, the canine had reached the occlusal plane perfectly. 
Conclusion: Bilateral impacted canines can be treated with a combination of surgical procedure and retraction with orthodontic treatment to achieve optimum occlusion and aesthetic function.