The Twilight Saga – Autoectopia

Attended an excellent lecture by Dr. Grubisa at Halton Peel the other night on ectopic eruption and impacted teeth – the orthodontic solutions for same.  Did a little literature search and came up with the following from a resident’s review.

Some treatment options for impacted maxillary canines can lead to unfavorable outcomes. Autotransplantation is an option that involves atraumatic surgical removal of the canine and reimplantation into a previously created socket. The aim of this study was to evaluate survival and success rates after autotransplantation of maxillary permanent canines with closed apices. The sample consisted of 49 patients (mean age at transplantation, 21.8 year),

Saber-toothed Cat

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who had autotransplantation of impacted maxillary canines. The sample was divided into 2 categories: 63 autotransplanted maxillary canines with no controls and 27 unilateral transplanted canines with a nontransplanted canine on the contralateral side as a control. Success was determined by using the following criteria: survival, mobility, probing pocket depth, gingival bleeding, vitality, color, internal and external inflammatory resorption, bone level, and signs of pathology. Thirty-eight percent of the sample was considered successful, and the overall survival rate was 83%, with an average duration of 14.5 years (range, 1.4-27.8 years). In the case control sample, the transplanted teeth had unfavorable differences compared with the nontransplanted teeth for probing pocket depth, gingival bleeding, vitality, and color, all of which were statistically significant. The results of this study indicate that autotransplanted canines with closed apices have a low complete success rate but can have a favorable survival rate over the long term. The technique should be considered as an interim measure to maintain bone level before placement of implants in patients who are unwilling to undergo lengthy orthodontic treatment to align ectopic canines.
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