Autotransplantation of retained canines unable to undergo orthodontic traction. A clinical report.

Abstract

Aim: The canine is the tooth that, together with the third molar, presents the highest risk of inclusion: 85% of these teeth are located in the palate and 15% in the buccal area. In most treatment plans, retained canines are driven to extrusion through orthodontic treatment. However, in some cases, for technical reasons or patient choice, it is not possible to perform this consolidated approach. The present clinical report evaluates 10 ectopic canines transplanted in both adults and younger patients with up to 60 months of follow-up.

Case description: Two clinical cases are described in detail with accompanying photographs and radiographs. In both of these cases, the retained canine was extracted, the receiving site prepared, a proper socket adapted through the use of implant osteotomy burs, and the canine transplanted into its ideal position. The tooth was fixed to the adjacent teeth for a variable period and healing was uneventful. After 60 months (Case 1) and 24 months (Case 2) of follow-up, the teeth did not show any color variation, the vitality tests were positive, and no signs of periapical reactions were detected.

Practical implications: The transplantation of included canines, even with a formed apex, seems to be a successful procedure, although it should be reserved for those cases where an orthodontic approach is not viable. This procedure is able to provide a natural tooth with proprioceptive function, capable of accompanying the natural growth of the patient's jaws, with consequent eruption together with the adjacent teeth.