Abstract
This case presents an unusual transposition of an impacted canine on the central incisor that provides a multidisciplinary approach to its resolution. The patient comes to the consultation for mobility of the central incisor. Clinically, tooth mobility was confirmed with tooth crowding and persistence of the temporary canine. Cone beam tomography (CBCT) observed the atypical position of the permanent canine that caused root resorption of the ipsilateral central incisor and the need to extract both teeth. The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant. The orthodontic treatment managed to correct the bite, position the upper premolar in the place of the canine tooth and maintain the space to place the implant in the central incisor. The three-year follow-up shows maintenance of the peri-implant crestal bone level, the success of orthodontic treatment with recovery of the patient’s function and aesthetics.
Highlights
The conservative treatment of the bone structures during the dental enucleation of the impacted canine carried out by odontosection and the immediate bone grafting of the defect projected an acceptable regeneration of the bone volume for the insertion of the implant
Photographs were used to evaluate the stability of the peri-implant soft tissues and to control orthodontic treatment
Mithridade et al suggest treatment alternatives other than the one proposed, such as the placement of implants through impacted teeth to avoid invasive surgery [10], its routine application is not justified due to the lack of patients with long-term follow-up. Another possible treatment approach chosen by Cruz consists of orthodontic traction of the impacted canine and its repositioning [11] but in our case, it would have a poor prognosis because the impaction is very deep with marked angulation and the root of the canine is fully formed
Summary
The case presented is unique because it presents an impacted canine in the un-. The maxillary canine is the most commonly impacted tooth followed by the mandibular canines. According to Al-Zoubi et al given the complexities, impacted canines can have a wide range of variations in their long axis and should be carefully evaluated during treatment planning [1]. Peck et al define dental transposition as the change of position of 2 adjacent teeth or not, especially in relation to their roots in the same quadrant of the dental arch, which develops and erupts in inverted positions and alters the normal sequence of the eruption [2]
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