The retrospective study of 93 patients with transmigration of mandibular canine and a comparative analysis with a control group

Pulp revascularization after autotransplantation of the mandibular canines with partially resected roots. Report of five cases with follow-ups between 26 and 80 months

INTRODUCTION

Transmigrated (migrated through the midline) mandibular canines constitute a treatment challenge. Advanced transmigration can be successfully treated by autotransplantation. In developing canines, pulp revascularisation is typical after transplantation. On the contrary, the pulp of teeth with completed apex formation does not undergo revascularization. In this case, root canal treatment becomes compulsory and decreases the success of autotransplantation. The aim of this observational retrospective study was to evaluate whether partial resection of the root (performed during the autotransplantation of mature canines) would enable revascularization of the pulp after the surgery.

METHODS

Five transmigrated mandibular canines with complete apex formation before the surgery were evaluated. During the autotransplantation surgery, the resection of 2-4 mm of the root apex was performed to open the path for revascularisation of the pulp after surgery. The transplanted teeth were observed during healing after the surgery for the presence of pulp obliteration. Clinical and radiographic examinations were performed.

RESULTS

All treated canines survived the minimum observation period of two years (ranging from 26 to 80 months, mean: 55 months) without pulp healing complications. The survival was 100 percent, and the success was 80 percent. In one canine, the external cervical root resorption was diagnosed and treated one year after the surgery. At the final examination, transplanted canines presented radiographic features of pulp obliteration, normal mobility, and healthy periodontal tissues.

CONCLUSIONS

The surgical protocol proved to be successful in promoting revascularization to maintain pulp vitality, in all cases. The outcomes confirm that autotransplantation, combined with the resection of the root, constitutes as a valid treatment for mature ectopic canines.

Orthodontic repositioning of a lingually positioned transmigrated mandibular canine

This case report presents the successful orthodontic repositioning of a transmigrated and lingually positioned mandibular canine with conventional mechanics. Treatment began with the aim of creating space for the four permanent canines that had not yet erupted. Cervical headgear, mesial slice, and extraction of the deciduous teeth were executed, but only the right canines erupted; moreover, the mandibular left canine had become lingually transmigrated. Multibracket therapy was performed with the orthodontic repositioning of both left canines in 2 steps. They were repositioned, and good alignment was obtained. To our knowledge, this is the first case report describing the orthodontic repositioning of a lingually transmigrated canine with conventional double-arch mechanics. This treatment was successful and without significant complications, even though this approach can be challenging and time-consuming.

Dental Transmigration: An Observational Retrospective Study OF52 Mandibular Canines

The aim of this study was to analyze the prevalence of transmigrated canines in a Spanish population by evaluating their clinical and radiological characteristics. The descriptive observational study obtained 6840 orthopantomographs from all patients seeking dental care in the years 2017-21 via the Patient Reception Service and Dentistry Service at the Faculty of Dentistry at the Complutense University of Madrid and the Central Hospital of the Red Cross of Madrid (Spain). In total, 52 patients presented transmigrated canines, establishing a prevalence of 0.76%. This sample comprised 28 women and 24 men. Whenever a transmigrated canine was identified, a CBCT scan was obtained and used to evaluate the clinical and radiological variables associated with canine transmigration. The predominant side of the transmigration was the left (57.69%) compared to the right side (42.30%). The position of the canine, in order of frequency, according to the Mupparapu classification, corresponded to type IV (42.30%), type II (36.53%), type I (15.38%), and type V (5.76%), with no type III transmigrations found. Clinical manifestations were only recorded in 17.30% of cases, and 11.53% of the radiological findings showed the presence of tooth cysts that were confirmed by histopathological studies. Other impactions, in addition to the transmigrated canine, were found in five patients (9.61%), with the majority being the presence of third molars.

Three-Dimensional Analysis of Impacted Maxillary and Mandibular Canines and Evaluation of Factors Associated With Transmigration on Cone-Beam Computed Tomography Images

PURPOSE

The aim of this study was to determine the prevalence of canine transmigration in the maxilla and mandible and to perform a 3-dimensional examination of impacted canines (ICs) on cone-beam computed tomography (CBCT) images.

MATERIALS AND METHODS

CBCT images of 35 transmigrated and 35 nontransmigrated canines (control group) were analyzed. Associations between gender, jaw, dental anomalies associated with ICs, adjacent lateral status, the status of deciduous canine, contact of the apical region with the cortex, contact of the crown with the cortex, canine location, resorption of adjacent teeth and severity, periodontal contour of adjacent teeth, odontoma, root status of the canine, cyst formation, and age groups of patients with transmigration were evaluated.

RESULTS

The prevalence of unilateral canine transmigration was 1.14%. Unilateral canine transmigration was less common in the mandible (0.52%) than in the maxilla (0.62%). ICs were significantly more frequently located on the lingual side. Resorption, the absence of contact between permanent and deciduous canines, and older age were significantly associated with transmigration. Resorption of adjacent teeth did not show significant differences according to transmigration status and gender, whereas nontransmigrated canines were significantly more commonly associated with periodontal destruction.

CONCLUSIONS

The status of associated deciduous canines, location on the lingual side, and older age may be associated with transmigration of ICs. Conversely, transmigration is not significantly associated with the destruction of adjacent structures. CBCT is a valuable tool for comprehensive evaluations of impacted and transmigrated teeth.