Alternative Methods of Repositioning Impacted Maxillary Canines in the Dental Arch-En Bloc Autotransplantation of a Tooth.

OBJECTIVES: Permanent anterior tooth impaction constitutes an esthetic and medical challenge. The treatment of choice is orthodontic-surgical alignment of the impacted tooth into the arch. The procedure often proves to be unattainable due to the impacted tooth's unfavorable position in relation to the adjacent teeth; therefore, the decision to proceed with it can cause severe and irreversible complications in the form of adjacent tooth resorption or occlusal plane derangement. We present a new treatment modality to be used for cases of impacted canines, which consists of en bloc autotransplantation of a fully impacted tooth to the correct position in the dental arch.

MATERIALS AND METHODS: Our study recruited patients with an impacted anterior maxillary canine tooth and an unfavorable prognosis due to its position in the arch after previous unsuccessful conventional orthodontic-surgical treatment. After orthodontic preparation, the problematic tooth was excised en bloc with adjacent bone and positioned correctly in the dental arch.

RESULTS: The transplanted teeth remained alive and achieved proper stability with physiological mobility.

CONCLUSIONS: Autotransplantation of an impacted, live, permanent tooth en bloc with adjacent bone is a new treatment modality with efficacy confirmed by short-term follow-up. It is the treatment of choice in cases where it is impossible to reposition a canine tooth with an orthodontic appliance. In view of the gathered data, adequate assessment and qualification of patients was crucial and allowed for a reduction in complications after unsuccessful orthodontic-surgical repositioning of impacted teeth.