Surgical and orthodontic management of maxillary canine-lateral incisor transpositions

Abstract

Transposition of the maxillary canine and the lateral incisor is a complex dental anomaly to treat. The difficulty increases if the treatment aims to correct the transposition. These case reports describe 2 patients with transposition of the maxillary lateral incisor and canine. The first case involves bilateral incomplete transpositions, and the second is a complete transposition. The radiographic appearance of the canine was similar in the 2 patients. However, the treatments were distinct because of the 3-dimensional positions of the teeth. The first case involved palatally placed lateral incisor roots. To prevent resorption of the lateral incisors, the canines were moved into position buccally. In the second case, the lateral incisor root had a buccal position, and the canine crown was tractioned palatally. The position of the lateral incisor root was critical when electing the correct treatment and mechanics for each patient.

Two-phase orthodontic treatment of two different types of tooth transposition in the same patient

“…At the end of treatment, a slightly greater root resorption of the right first maxillary premolar was observed, perhaps due to greater forces applied on it to control root inclination and angulation (Figure 6). The short treatment time and the use of light forces may have contributed to the clinically acceptable resorption compared to similar cases in the literature (Lorente et al, 2016;Nishimura et al, 2012;Yan et al, 2012). The gingivae of the transposed teeth showed no signs of inflammation or recession.…”

Orthodontic management of a complete and an incomplete maxillary canine-first premolar transposition

“…The less the canine has descended into its position, the wider the dentoalveolar process will be; this provides the opportunity to move the teeth within the bone and decreases the risk of negative effects. 23 In this case report, one of the main disadvantages was that the initial position of the canine crowns was not as high as desired to benefit the correction of the transposition. This was a challenge when designing the correct vector of traction, making the canine of the complete transposition move upward in order to avoid root contact during the displacement (Figure 4).…”

“…14 However, other authors reported cases in which transpositions have been corrected. 23,24 Canines are essential both for function, providing canine guidance for occlusion, as well as for esthetics, giving the patient correct dental and gingival symmetry. 21 In addition, from a facial esthetics point of view, the canine eminence provides support to the nasolabial fold, which will help the patient have better facial aging, and a greater sense of width in the smile is achieved.…”

Tooth transposition: a multidisciplinary approach

“…On the other hand, as the prevalence of the condition is relatively low, there is a lack of studies to aid determining not only the most effective treatment modality, but also the most convenient moment to begin. 24 …”