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| 1. Diagnosis of palatal mucosal impaction of the left upper canine (2.3) by clinical and radiological recordings. |
| 2. Definition of treatment objectives: surgical-orthodontic disinclusion of impacted 2.3 by diode laser and its orthodontic translation in the arch after extraction of 6.3. |
| 3. Obtaining informed consent from the patient’s parents to proceed with surgical-orthodontic disinclusion. |
| 4. Performing an upper silicone impression for the fabrication of a trans-palatal bar (TPB) with a hook for orthodontic traction of 2.3 impacted. |
| 5. After application of the orthodontic separators, cementing and light-curing the TPB on the upper first permanent molars. |
| 6. Wearing safety glasses and performing local anaesthesia. |
| 7. Performing a diode laser surgical operculectomy with the following parameters: 810 nm wavelength, continuous wave mode with a power output of 3 W, and a 0.4 mm diameter optical fiber. |
| 8. Adhesion of the orthodontic bracket to achieve orthodontic traction. |
| 9. Etching of the enamel with 35% phosphoric acid applied for 20–30 seconds and rinsing for an equivalent time. |
| 10. Drying using aspiration to obtain the chalky white appearance of the enamel. |
| 11. Application of light cure adhesive on the enamel and on orthodontic bracket baseplate using a Microbrush®. |
| 12. Positioning of the orthodontic bracket and application of continuous pressure for a light curing time of twice 20 seconds under constant suction. |
| 13. Immediate traction with an elastic connected to the wire: if an error has been made in the bonding protocol, the orthodontic bracket is immediately taken off and a new bonding procedure is begun. |
| 14. Placement of the orthodontic bracket with a passive metal looped ligature, secured with composite. |
| 15. Discharge the patient with necessary postoperative instructions for maintenance of good oral hygiene and keeping the area clean. |
16. See the patient 2 weeks after surgery, twice, and monthly thereafter.
Application of active elastic traction on 2.3 after 2 weeks and upper arch bonding one month after surgery through Straight-Wire MBT™ technique with a 0.14″ NiTi arch-wire, performing a mesial lace-back 1.2–2.2 and metal ligation on 2.2. |
| 17. Progressive translation of the canine into the correct position in the dental arch through reactivations of elastic traction with elastic cotton threads, lace-back 1.2–2.2, metal ligatures on 2.2 and 2.4 and super elastic NiTi (0.12) upper arch. |
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