Transmigrant mandibular canine – Case report

Abstract

r e v p o r t e s t o m a t o l m e d d e n t c i r m a x i l o f a c . 2 0 1 5;5 6(1):63-67 Mandible Cuspid Pathology Impacted tooth a b s t r a c tTransmigration is a rare and special phenomenon in that intraosseous tooth migration takes place, through the midsymphyseal or mid palatine suture. Transmigration typically affects the mandibular canines. These teeth usually remain impacted and asymptomatic but in some cases they ectopically erupt in the midline or next to the contralateral side. Transmigrated teeth can cause neurologic symptoms and pressure resorption of the adjacent teeth roots. A 15-year-old girl was referred to our clinic complaining of pain in the inferior incisives. On intraoral examination, right mandibular deciduous canine was seen to be retained. Panoramic radiograph revealed a horizontally impacted right mandibular permanent canine migrated toward the midline and located below the apices of the incisives. The tooth was surgically removed under general anesthesia. The presence of an overretained mandibular deciduous canine should always be investigated radiographically. © 2015 Sociedade Portuguesa de Estomatologia e Medicina Dentária. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Transmigração de canino mandibular impactado -Caso Clínico Palavras-chave:Erupção dentária ectópica Mandíbula Canino Patologia Dente impactado r e s u m o A transmigração é um fenómeno raro no qual dentes não erupcionados migram através da linha média maxilar ou mandibular. A transmigração, geralmente, afeta os caninos mandibulares. Normalmente estes dentes permanecem impactados e assintomáticos mas em alguns casos podem erupcionar na linha média ou na região do canino contralateral. Os dentes transmigrados podem originar sintomas tais como dor ou reabsorção das raízes dos dentes adjacentes. Uma menina de 15 anos de idade compareceu a nossa consulta referindo dor nos incisivos inferiores. Ao exame clínico foi possível verificar a presença na arcada do canino mandibular direito decíduo. A radiografia panorâmica revelou que o canino permanente mandibular direito se encontrava impactado numa posição horizontal abaixo

Piezosurgery-Assisted Surgical Treatment in Impacted Canine Transmigration

“…Orthodontic traction and self-transplants were found in the literature as treatment options for impacted canines [6]. However, these are time-consuming and expensive treatments [2].…”

“…In human dentition, mandibular and maxillary canines are teeth that have relevance both in aesthetics and occlusion [1][2][3][4][5]. A small manifestation such as a cyst or root fragment or mandibular trauma at an early age can cause dental deviation that may lead to impaction [3,6]. Common precipitating factors are neighboring tooth lesions, infection, ectopic eruption, and interference with prosthesis [2].…”

“…Most impacted canines are clinically asymptomatic and do not cause pain or discomfort [3,6,7]. A high index of suspicion should exist for canine impaction in the case of delayed eruption and a slight elevation in the palatal or vestibular mucosa [7].…”

“…Transmigration cases, where the unerupted tooth migrates and crosses the midline, are less frequent [5,6,9]. Studies show that the canines are the only teeth in the dental arch able to cross the midline [3].…”

“…This form of impaction occasionally occurs in the maxillary region; however, canine transmigration is more common in the mandible [10,11]. In most cases, periapical radiographs are not sufficient to detect transmigrated canines, making a panoramic radiograph essential [6].…”