Complications after autotransplantation of a maxillary canine: a case report and literature review

The permanent maxillary canine has a pivotal role in facial and dental aesthetics, occlusion, lip support and phonetics. Second to the third molar, the permanent maxillary canine is the second most frequently impacted tooth, with a prevalence of 1.5%. Of these, literature states that 85% are palatally impacted and 15% labially impacted.¹

Autotransplantation is the positioning of a tooth in the same individual, from a donor site to an extraction site or a surgically prepared socket, and remains a documented alternative treatment option for managing impacted canines.² Autotransplantation of teeth has been carried out for many years globally with varying degrees of success. The earliest well-documented case was in 1954 by ML Hale, with some principles of his technique still followed today.³ In the last 30 years, the work of Andreasen et al, in conducting long-term studies of autotransplanted teeth, has been pivotal in establishing a protocol for this treatment.^4,5,6 With the development of new technologies however, dental autotransplantation is not typically an option contemplated immediately, but is considered useful in several clinical scenarios that are discussed later in the article. The traditional treatment options for managing impacted canines include: interceptive removal of the deciduous canine; surgical exposure with orthodontic traction; or surgical removal with a combined orthodontic–restorative approach. Thus, canine autotransplantation is not routinely considered unless the traditional modalities are deemed inappropriate or prove to be unsuccessful.⁷ The procedure is highly technique-sensitive. Careful attention to treatment planning in selected patients, along with thorough understanding of the biological concepts of healing, is essential for favourable prognosis.