A patient with transmigrated mandibular selleck catalog right canine and impacted two lower incisors probably related to earlier trauma was presented in case 4. But, unfortunately, it is not sure whether these teeth were central or lateral incisor without surgery. According to Camileri,3 impacted mandibular lower incisor teeth might be called as transmigrated teeth. This case showed that eruption abnormalities might affect more than one type of tooth.16 While most of the transmigrated mandibular canines occurred unilaterally,1,2,4,5,7,9,11,17,19 only 9% of them were bilateral.1,6 Although most of the bilateral transmigrated canines lied horizontally, there were no bilateral transmigrated teeth which were in vertical position. In case 3, while 33 lied vertically in the midline, 43 lied vertically between apices of the 41 and 42 because of inadequate space to cross.
It can not be suggested that both canines crossed the midline completely. In bilateral transmigration cases which canines lied in vertical position, it is impossible for both canines to cross the midline simultaneously. Transmigrated mandibular canines were classified according to Mupparapu.17 It could be summarized as; Type 1: The impacted canine is mesioangularly acrossing the midline, labial, or lingual to the anterior teeth with the crown portion of the tooth crossing the midline. Type 2: The canine is horizontally impacted near the inferior border of the mandible below the apices of the incisors. Type 3: The canine has erupted either mesial or distal to the opposite canine.
Type 4: The canine is horizontally impacted near the inferior border of the mandible below the apices of either premolars or molars on the opposite side. Type 5: The canine is positioned vertically in the midline with the long axis of the tooth crossing the midline. Mupparapu��s classification consisted of single transmigrated canine. In case 3, bilateral impacted canines in vertical position located in the midline was in accordance with Type 5. Besides the option of surgical removal, transplantation and surgical exposure with orthodontic alignment are treatment alternatives for the transmigrated teeth.2 A long term follow up without symptoms may be an alternative option for patients who are afraid of surgical processes. Migrated tooth must be detected in early stages of its migration for orthodontic treatment.
If it can not be detected early, further treatment alternatives will lessen and the case might get worse. Surgical extraction is more appropriate than others in case of a pathological situation. Consequently, decision of treatment options relates to pathological conditions, location and position of the transmigrated tooth and patient��s desire. In present study, only one Dacomitinib of our 4 patients preferred surgical treatment (in case 2) and others went under follow up. The transmigrated canine, which was the subject of case 1, located near the mandibular canal.