Surgical transpose of an impacted maxillary canine with bone flap replacement

Introduction: Management of an edentulous area when the tooth is impacted is often a challenge. Usually, treatments are by far orthodontic traction followed by tooth removal with dental implant placement. With piezosurgery, minimally invasive auto-transplantation can be an alternative. Observation: A 27-year-old patient presenting terminal mobility of the tooth no°63 consulted for replacement. Among the different therapeutic solutions, a surgical transposition of her impacted tooth no°23 with a conservative bone window replacement was decided. After a 12-month follow up period, X-rays showed no sign of ankylosis, root resorption or apical pathology, while clinical criteria such as tooth function, mobility and aesthetic integration were all satisfying. Commentaries: Space closure, dental implant and bonded bridge were alternatives. The interest of this clinical case is to restore the functional and aesthetic roles of the canine without compromising any potential implant placement later. Also the patient can still have the possibility to opt for an implant-supported crown in the long-term thanks to the bone volume maintained. Conclusion: When orthodontic realignment is considered as not possible, auto-transplantation of a tooth can be a good choice before going on dental implant therapeutic.