Orthodontic management of a dental anomaly pattern (DAP) including mandibular canine transmigration: A case report: A challenging treatment but worth it!

Abstract

Orthodontic technology has advanced to the point where management of cases with multiple dental anomalies should be within an orthodontist's daily armamentarium. A patient with bilateral agenesis of lower second premolars, delayed development, and transmigration of a mandibular canine was treated with the aid of hemisection, indirect/closed exposure, application of continuous force, targeted delivery, and strict attention to keeping the roots as much in bone as possible. This was accomplished without implants or flattening the facial profile, yet with excellent periodontal status and a fully functioning occlusion.

Transmigrated mandibular canines: clinical considerations and orthodontic biomechanics for the approach of orthodontic traction. A scoping review

“…articles of the 18 full-text articles retrieved (Agarwal et al, 2013;Cavuoti et al, 2016;Jaisinghani et al, 2019;Janakiraman et al, 2016;Koszowskiet al, 2015;Kuftinec et al, 1995;Kulkarni, & Lee, 2016;Northway, 2019;Peerlings, 2010;Plaza, 2016;Shukla et al, 2019;Sinko et al, 2016;Üçüncüet al, 2011;Umashree et al, 2013;Vaidaet al, 2014;Vera-Guerraet al, 2019;Verma et al, 2012;Wertz, 1994) were excluded because of the following: in three articles, the treatment included the extraction of the canine (Janakiraman et al, 2016;Kuftinec et al, 1995;Umashree et al, 2013), two articles were related to the autotransplantation approach (Kulkarni, & Lee, 2016;Verma et al, 2012), and one study focused on a non-transmigrated canine (Agarwal et al, 2013). Apart from case reports and cohort studies, no other design was found during the search.…”

“…Apart from case reports and cohort studies, no other design was found during the search. After the exclusion criteria had been met, 12 full-text articles (Cavuoti et al, 2016;Jaisinghani et al, 2019;Koszowski et al, 2015;Northway, 2019;Peerlings, 2010;Plaza, 2016;Shukla et al, 2019;Sinko et al, 2016;Üçüncü et al, 2011;Vaida et al, 2014;Vera-Guerra et al, 2019;Wertz, 1994) remained to be retrieved and examined for further evaluation. The characteristics of the included studies are summarized in Figure 1, and the key findings about the orthodontic biomechanics and clinical considerations were collected and are summarized in Tables 3 and 4.…”

“…The resources found for diagnosis and etiology were clinical examination and additional images, such as panoramic cephalometric radiographs (Cavuoti et al, 2016;Jaisinghani et al, 2019;Northway, 2019;Peerlings, 2010;Shukla et al, 2019;Üçüncü et al, 2011;Vera-Guerra et al, 2019;Wertz, 1994) and computed tomography (CT) images (Koszowski et al, 2015; Legend: CR: case report; yo: years old; y: years; m: month; PC: permanent lower canine tooth; DC: deciduous lower canine tooth; A/N; alignment and leveling; ML: metallic ligature; GL: gold ligature; TAD's: temporary anchorage devices. Source: Authors.…”

“…Orthodontic biomechanics (Tables 3 and 4) Different forms of interventions and procedures related to the management of TMC traction protocols were reported in the selected papers (Cavuoti et al, 2016;Jaisinghani et al, 2019;Koszowski et al, 2015;Northway, 2019;Peerlings, 2010;Plaza, 2016;Shukla et al, 2019;Sinko et al, 2016;Üçüncü et al, 2011;Vaida et al, 2014;Vera-Guerra et al, Research, Society and Development, v. 10, n. 3, e21210313376, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i3.13376 1994). In addition, these protocols described tractions (Cavuoti et al, 2016;Jaisinghani et al, 2019;Koszowski et al, 2015;Northway, 2019;Peerlings, 2010;Plaza, 2016;Sinko et al, 2016;Üçüncü et al, 2011;Vaida et al, 2014;Vera-Guerra et al, 2019;Wertz, 1994), by means of orthodontic forces, some requiring surgical intervention and, when the TMC was already erupted, no surgical approach was applied other than orthodontics ( Shukla et al, 2019).…”

“…Whether or not surgical approaches were needed to access the TMC, they were performed under general (Peerlings, 2010) or local anesthesia (Cavuoti et al, 2016;Plaza, 2016;Sinko et al, 2016;Üçüncü et al, 2011). The surgical access to the TMC was obtained with: (a) dental exposure, accessory bonding, and flap closure (Cavuoti et al, 2016;Jaisinghani, et al, 2019;Koszowski et al, 2015;Northway, 2019;Peerlings, 2010;Plaza, 2016;Sinko et al, 2016;Vaida et al, 2014;Vera-Guerra et al, 2019;Wertz, 1994); (b) the open technique (Üçüncü et al, 2011); (c) with cauterization and subsequent traction from the open field (Jaisinghani, et al, 2019). When applied, surgical synthesis was performed in a single plane and with silk thread (Peerlings, 2010).…”