Survival and success of autotransplanted impacted maxillary canines during short-term follow-up: A prospective case-control study.

OBJECTIVES: This prospective clinical trial aimed to examine the predictability of maxillary canine transplantation as compared to biological canine eruption. Additional objectives were to examine hard and soft tissue outcomes, including aesthetic outcome compared to outcomes with the contralateral canines. SETTINGS AND SAMPLE POPULATION: The sample comprised 17 consecutively transplanted maxillary canines in 17 patients (mean age at surgery, 18 years; range, 11-29 years). Minimal follow-up time was 12 months post-transplantation. Clinical and radiographic parameters were recorded for the transplanted and contralateral canines, showing a natural eruption pattern. MATERIAL AND METHODS: The Maxillary Canine Aesthetic Index (MCAI) and the Autotransplanted Maxillary Canine Radiological Index (AMCRI) were scored for all upper canines. Successful transplantation was considered as the absence of pathology during intermittent clinical and radiographic controls and a good-to-excellent outcome compared to the contralateral biological erupted canine, as defined by the MCAI and AMCRI. RESULTS: The mean follow-up period was 28 months (±9; range, 12-40 months). The overall survival rate was 100%, and the success rate reached 68% at 1 year post-operatively. Significant predictors of success were the extra-oral time during transplantation, amount of damage to the root surface, quality of surrounding tissues and immediate post-operative oral hygiene. CONCLUSION: Standardized measurements demonstrated clinically satisfactory outcomes with maxillary canine autotransplantation compared to outcomes with the contralateral canine during 1-3 years of follow-up. The potential predictors of success identified here should be confirmed with long-term follow-up studies.

Surgically assisted orthodontic alignment of impacted maxillary canines: A retrospective analysis of functional and esthetic outcomes and risk factors for failure.

INTRODUCTION: The initial position of an impacted maxillary canine might influence the outcome of surgically assisted exposure and orthodontic alignment. Therefore, the purpose of this study was to evaluate existing correlations between the initial position of the maxillary canine and the outcomes of treatment. METHODS: A retrospective cohort study was designed, containing data of 132 patients (47 males, 106 females; median age at the date of surgical exposure 14 ± 4.6 years; range, 10-39 years) with a total of 153 impacted maxillary canines. The sample was based on orthodontic referrals over 4 years at the Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, the Netherlands. The esthetic outcome, treatment duration, and success and failure rate were investigated in relation to the initial position of the maxillary canine as assessed on pretreatment panoramic radiographs (vertical and anteroposterior sector position and angulation of the canine [α-angle]). The esthetic evaluation was performed using the Maxillary Canine Aesthetic Index. The success of treatment was defined as achieving a fully functional eruption of the canine, with an esthetically excellent result, without the need for reinterventions. Failure of treatment was defined as the need for reintervention or removal of the canine. RESULTS: In 96% of the impacted canines, a successful orthodontically assisted eruption was achieved. Age, vertical distance, and angulation are predictors of the esthetic outcome of impacted canines after treatment. Age, bilateral impaction, sector, vertical distance, and angulation are predictors of treatment duration. Age, vertical distance, and buccolingual position are predictors of the need for reintervention. CONCLUSIONS: Pretreatment radiographic variables can help in predicting the outcome and treatment duration of surgically exposed maxillary impacted canines.