title: Management of severely impacted mandibular canines and congenitally missing mandibular premolars with protraction of autotransplanted maxillary premolar.
abstract: Transmigrated mandibular canines increase the treatment complexity in terms of both anchorage and biomechanical planning. Additionally, a Class II malocclusion with a deep overbite and associated dental anomalies such as hypodontia can further increase the treatment complexity and the overall treatment time. This case report describes the successful interdisciplinary treatment of a patient, aged 12.5 years, with transmigrated and severely impacted mandibular canines and congenitally missing mandibular second premolars. The transmigrated mandibular right canine was extracted, and a maxillary second premolar was autotransplanted to the missing mandibular right second premolar site with the aid of a stereolithographic donor tooth replica fabricated with 3-dimensional cone-beam computed tomography and a rapid prototyping technique. Furthermore, the autotransplanted tooth was protracted by 4 to 5 mm to close the space caused by the extraction of the mandibular right canine. The impacted mandibular left canine was orthodontically guided into its normal position in the arch. Good esthetic outcome and functional occlusion were achieved.
authors.affiliation: Assistant professor, Division of Orthodontics, Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut, Farmington, Conn. Electronic address: janakiraman@uchc.edu.
authors.forename: Nandakumar
authors.initials: N
authors.lastname: Janakiraman
authors.affiliation: Private practice, Houston, Tex.
authors.forename: Hamed
authors.initials: H
authors.lastname: Vaziri
authors.affiliation: Professor and chair, Division of Endodontology, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: Kamran
authors.initials: K
authors.lastname: Safavi
authors.affiliation: Professor and head, Department of Craniofacial Sciences, Alumni Endowed Chair, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Nanda
authors.affiliation: Associate professor and program director, Division of Orthodontics, Department of Craniofacial Sciences, Charles Burstone Professor, School of Dental Medicine, University of Connecticut, Farmington, Conn.
authors.forename: Flavio
authors.initials: F
authors.lastname: Uribe
mesh_terms: D000848:Anodontia / Q000000981:diagnostic imaging / Q000628:therapy*; D064592:Autografts; D001641:Bicuspid / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000637:transplantation*; D002508:Cephalometry; D002648:Child; D003481:Cuspid / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008334:Mandible / Q000002:abnormalities / Q000000981:diagnostic imaging; D008437:Maxilla; D003765:Models, Dental; D011862:Radiography, Panoramic; D014087:Tooth Movement Techniques; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000601:surgery*