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Case Reports
. 2024 Sep 19;16(9):e69738.
doi: 10.7759/cureus.69738. eCollection 2024 Sep.

Comprehensive Management of Mandibular Canine Transmigration: A Multidisciplinary Approach

Ashish K Singh  1 , Dhruv Ahuja  1 , Puneet Batra  1 , Priya Dogra  1 , Toni Lego  1
Affiliations
Case Reports

Comprehensive Management of Mandibular Canine Transmigration: A Multidisciplinary Approach

Ashish K Singh et al. Cureus. .

Abstract

Transmigration of mandibular canine teeth is a rare dental anomaly characterized by the tooth's aberrant migration through the alveolar bone. This deviation from the expected eruption pathway can lead to tooth impaction, root resorption, periodontal problems, and aesthetic concerns. The exact cause of transmigration is not fully understood, but it is believed to be influenced by a combination of genetic, developmental, and environmental factors. Early diagnosis and appropriate treatment are essential to prevent complications and achieve optimal functional and aesthetic outcomes. This case report presents a 19-year-old female with impacted left mandibular canine teeth. An interdisciplinary approach involving orthodontic therapy and surgical exposure to disimpact the transmigrated canine into the normal occlusal position. The treatment utilized modified orthodontic mechanics, including uprighting springs and temporary anchorage devices (TADs) to treat transmigration. This case also highlights the importance of early diagnosis and timely intervention for transmigrated canine teeth to prevent complications and achieve optimal aesthetic and functional outcomes.

Keywords: impaction; mandibular canine; tads; transmigration; uprighting spring.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Pre-treatment extraoral photographs: frontal view (A), frontal smiling view (B), and profile view (C)
Figure 2
Figure 2. Pre-treatment intraoral photographs: right occlusion (A), anterior occlusion (B), left occlusion (C), maxillary arch (D), mandibular arch (E)
Figure 3
Figure 3. Pre-treatment radiographs showing impacted mandibular canine (yellow arrow): lateral cephalogram (A) and OPG (B)
OPG: orthopantomogram
Figure 4
Figure 4. Pre-treatment CBCT scan showing impacted mandibular canine in relation with mandibular incisors and alveolar bone in three dimension: hard tissue reconstruction (A to C) (yellow arrows), reconstructed OPG section focusing on canine impaction (D) (blue arrow), axial and sagittal views (E to H) (green arrows)
CBCT: cone beam computed tomography; OPG: orthopantomogram
Figure 5
Figure 5. Uprighting spring made up of 0.017 x 0.025 TMA wire placed to the bracket the canine and TAD
TMA: Titanium molybdenum alloy; TADs: temporary anchorage devices
Figure 6
Figure 6. Elastic force traction for retraction of mandibular canine from TAD to round button on canine (white arrows): right occlusion (A), anterior in occlusion (B), left occlusion (C), maxillary arch (D), mandibular arch showing space available for permanent mandibular canine after extraction of deciduous canine (E)
TADs: Temporary anchorage devices
Figure 7
Figure 7. Elastic force traction of mandibular canine in vertical plane from rigid arch wire(white arrows): right occlusion (A), anterior in occlusion (B), left occlusion (C), maxillary arch (D), mandibular arch (E)
Figure 8
Figure 8. Finishing stage with settling elastics and Warren root torquing spring placed to provide lingual root torque for mandibular left canine: right occlusion (A), anterior in occlusion (B) (yellow arrows), left occlusion (C) (yellow arrows), maxillary arch (D), mandibular arch (E)
Figure 9
Figure 9. Post-treatment radiographs showing the final position of the mandibular canine and associated dental and bony components: lateral cephalogram (A), OPG showing root parallelism and adequate bony support around the canine (B) (yellow arrow). Pre and post-treatment cephalometric superimposition (C)
OPG: orthopantomogram
Figure 10
Figure 10. Post-treatment extraoral photographs: frontal view (A), frontal smiling view (B), and profile view (C)
Figure 11
Figure 11. Post-treatment intraoral photographs: right occlusion (A), anterior in occlusion (B), left occlusion (C), maxillary arch (D), and mandibular arch (E)
See this image and copyright information in PMC

References

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