Impacted cuspid, palatal extraction

This case shows the extraction of a maxillary canine, impacted  in the palate.

I open a flap in the palate, preserving the papilla, so I can stitch the flap back again. I calculate the position by the x-ray and start drilling the bone with a hand-piece until I touch the tooth. I know that because of its different hardness.

I remove as much bone as I need to see the crown and I cut it with a high speed turbine drill. I keep removing bone until I can pull out the crown split part of the cuspid.

I work my way to remove the root end of the tooth, the soft tissue capsule, and I stitch the palate flap back in place.

Literature speaks of swallowing or difficult, painful bonding of the palate flap over the bone. It is convenient to prepare a Hawley-type splint, or simpler, a silicone cast that the patient can bite on intervals. This applies enough compression on the palate to minimize swallowing, conducting to adequate healing.