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Regular discussions between the Departments of Oral Surgery and Orthodontics at Göteborg University have resulted in a modified operative technique for impacted maxillary canines, called transalveolar transplantation. After exposure of the operation field, large amounts of bone are removed, avoiding damage to the surface of the cementum and the periodontal membrane. Throughout the surgical procedure the tooth is kept in the alveolar process and then finally gently moved to its desired position. Orthodontic fixation is used to stabilize, not to immobilize, the tooth. So far 101 maxillary canines have been autotransplanted in 85 patients (11-76 years old) with an observation period of 1-17 years. Transalveolar transplantation is considered a good alternative for impacted maxillary canines, provided that the treatment planning is discussed by an orthodontist and an oral surgeon together and the treatment is performed with meticulous surgical techniques and adequately functioning orthodontic fixation and used in patients with proper oral hygiene.

This follow-up study on transalveolar transplantation includes 56 maxillary impacted canines in 47 patients, with a post-operative control period of 2-10 years (mean 4.7 years). The prognosis of the transplanted teeth is still very good; only two canines have been lost, due to poor oral hygiene or fracture of the tooth. These positive follow-up results indicate that transalveolar transplantation will offer greater flexibility in the treatment of impacted maxillary canines in adults.