Orthodontic correction of a complete maxillary canine–first premolar transposition

Abstract

Tooth transposition is the positional interchange of adjacent teeth, with a prevalence of 0.33%, often linked to genetic factors or supernumerary or retained deciduous teeth. In complete transpositions, both crowns and roots are displaced; in incomplete transpositions, only the crowns are affected. This case report describes an 11-year-old white female patient undergoing orthodontic treatment because of concerns regarding the complete transposition of the maxillary left canine and the maxillary left first premolar. The report highlights the realignment of these teeth to their proper anatomic positions. Despite the risks of periodontal compromise and prolonged treatment duration, the parents chose to correct the transposition, aiming to reduce the need for restorative procedures after treatment. The segmented mechanics were carefully planned and tailored to minimize risks and side effects. The transposition was corrected orthodontically over 25 months, but the treatment was completed in 48 months by moving the teeth to their desired positions without any detrimental effects on the adjacent teeth. Despite the long treatment time, all objectives were achieved. Transposed teeth can be brought into their correct positions, with feasible results, if the canine is not fully erupted. Otherwise, maintaining the transposition is appropriate if the involved teeth are fully erupted and completely aligned in the transposed position.

Tooth transposition is the positional interchange of adjacent teeth, with a prevalence of 0.33%, often linked to genetic factors or supernumerary or retained deciduous teeth. In complete transpositions, both crowns and roots are displaced; in incomplete transpositions, only the crowns are affected. This case report describes an 11-year-old white female patient undergoing orthodontic treatment because of concerns regarding the complete transposition of the maxillary left canine and the maxillary left first premolar. The report highlights the realignment of these teeth to their proper anatomic positions. Despite the risks of periodontal compromise and prolonged treatment duration, the parents chose to correct the transposition, aiming to reduce the need for restorative procedures after treatment. The segmented mechanics were carefully planned and tailored to minimize risks and side effects. The transposition was corrected orthodontically over 25 months, but the treatment was completed in 48 months by moving the teeth to their desired positions without any detrimental effects on the adjacent teeth. Despite the long treatment time, all objectives were achieved. Transposed teeth can be brought into their correct positions, with feasible results, if the canine is not fully erupted. Otherwise, maintaining the transposition is appropriate if the involved teeth are fully erupted and completely aligned in the transposed position.