Abstract
This scoping review aims to identify the clinical considerations and orthodontics biomechanics of applying the orthodontic traction approach to transmigrated mandibular canines. The search strategy followed the PRISMA for scoping reviews and was based on six databases, Cochrane C.R.C. Trials, BVS, PubMed (NLM), Google Scholar, Web of Science, and SCOPUS, and included articles published as recently as February 2021. The records had to identify lower canines traction protocols and outcomes. The publications obtained had to meet criteria for the structure of the research and bibliography. The search included combinations of the keywords lower canine, cuspid, and transmigration, along with the terms biomechanics and scoping review in the databases. Only after a consensus of the three reviewers had been reached were the articles retrieved. When a transmigrated lower canine has already erupted, orthodontics biomechanics traction begins by bonding tooth buttons and/or bracket prescriptions: MBT 0.022” x 0.028”, Roth 0.018” x 0.022”, and/or Beggs rectangular arches, ligatures, and elastics. Surgical interventions may be added. The treatment time varied from 22 months to 3.6 years. The final occlusal relationships were satisfactory and did not cause damage to the surrounding tissues. Among the selected articles, the orthodontic biomechanics showed the complexity of the movements. An appropriate occlusion and stability were achieved. Failures in the approach were also found. The clinical considerations show this approach to be viable but to have inherent risks, which include the proximity of the canines to the lower incisor roots.
Highlights
The term ectopia is used to describe the placement of two contiguous teeth when their position has changed; the teeth are said to be transposed (Chattopadhyay & Srinivas, 1996; Peck, 1993; Peck, 1998)
Whenever the ectopia is extended beyond a single tooth displacement in the mandible and involves the lower canine, which almost always moves in the mesial direction (Röhrer, 1929; Shapira & kuftinec, 2005)
The search used the keywords transmigration, lower canines cuspids, biomechanics; and scoping review, which were crossed with combinations of the term biomechanics and protocols in all the included electronic databases. (Table 1) Regarding the study selection, two reviewers (LB and LE) searched for publications by initially reading their titles and abstracts, followed by analyzing the words contained in the title and abstract of the retrieved papers and analyzing the index terms used to describe the articles
Summary
The term ectopia is used to describe the placement of two contiguous teeth when their position has changed; the teeth are said to be transposed (Chattopadhyay & Srinivas, 1996; Peck, 1993; Peck, 1998). Whenever the ectopia is extended beyond a single tooth displacement in the mandible and involves the lower canine, which almost always moves in the mesial direction (Röhrer, 1929; Shapira & kuftinec, 2005). A form of intraosseous migration can result in a canine crossing the midline, characterizing transmigration (Kara et al, 2011; Röhrer, 1929; Shapira & kuftinec, 2005). The incidence of transmigrated mandibular canine (TMC) varies from 0.075%* to 0.34% (Aydin et al, 2004; Mazinis et al, 2012). The correct etiology of TMC is still unknown, but cysts, odontomas, and anomalies of the lateral incisors contribute to the incidence of this condition (Dalessandri et al, 2017). The earliest treatment protocol used a pin and eyelet inserted into the crown in an impacted canine to facilitate the guidance of the tooth that had failed to erupt. (Wertz, 1994)
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