Ectopic canine teeth develop displaced from their normal position.  Any permanent tooth can be ectopic and the cause may be both genetic and environmental.  Orthodontic treatment is justified because ectopic canine teeth can migrate in the jaw bone and may damage the adjacent incisor teeth roots and bone.  Orthodontic treatment is also justifiable for aesthetic reasons.  Treatment options include simple extraction of the ectopic tooth, open space to encourage spontaneous eruption, surgical exposure and orthodontic traction  and surgical extraction and orthodontic space closure

Treatment of ectopic canine teeth : Extraction of the ectopic tooth

A simple treatment option for ectopic canines is extraction without orthodontic treatment.  If there is aversion to orthodontic treatment and / or significant overcrowding this may be suitable.  However this may have undesirable aesthetic effects such as the shift of the upper dental midline as in this case where the upper right canine  was extracted.  Simple extraction therapy is only aesthetically acceptable if the remaining dentition is already well aligned and tooth replacement or substitution is possible.

Treatment for ectopic canine : Open space to encourage spontaneous eruption

Mildly ectopic  teeth may spontaneous erupt once enough space is made available orthodontically, like the case below.

Surgical exposure and orthodontic traction of ectopic canine teeth

When canine teeth are more severely displaced it is necessary to align the buried tooth with braces following surgical placement of an attachment, as simple space creation will not be successful.  When a buried tooth is aligned, a bracket is first glued to the tooth during a minor surgical operation. The ectopic tooth is brought into the mouth by gently pulling on it using braces.  You can see the second case below shows the gold chain appearing through the gum

Treatment of ectopic canine teeth : Extraction and space closure

Ocasionally it is preferable to consider extraction of the ectopic tooth and close the space, especially where the ectopic tooth is unfavorably positioned and requires space for incorporation into the arch (necessitating other tooth extractions) such as this case  with an ectopic 13 and 12 in crossbite