CANINE–LATERAL INCISOR TRANSPOSITION CORRECTION: A CLINICAL CASE STUDY

Abstract

Background: Tooth transposition is defined as an abnormality in the position of teeth in the same quadrant that are interchanged within the dental arch. Although rare, this abnormality can cause aesthetic and functional problems. The permanent maxillary canine is the most frequently transposed tooth. Objective: This study aims to provide evidence that anatomical correction can be a feasible alternative in carefully selected cases to achieve favorable functional and esthetic outcomes. Case: This case report describes the successful treatment of a left maxillary canine transposed with a lateral incisor. A 16-year-old female patient presented with crowding of the upper anterior teeth, negatively impacting esthetics. The left maxillary canine erupted between the lateral and central incisors, and primary tooth 63 remained intact. A fixed orthodontic appliance with a straight wire system was used in a 0.022 bracket slot to initiate active treatment. Tooth 23 erupted ectopically between teeth 21 and 22, while the retained primary tooth 63 occupied its expected position. Case Management: To facilitate distal movement of tooth 23, it was retained and bonded to the upper left posterior teeth (24, 25, and 26) using an elastomeric chain with very light force. After tooth 23 approached the location of tooth 63, the deciduous tooth was removed, and gradual vertical traction was applied using a 0.12 NiTi wire, followed by a larger diameter NiTi wire and rectangular stainless steel to achieve the correct root position and angle. The correction of complete lateral canine-incisor transposition has a high risk of root resorption and periodontal complication. However, this study successfully performed anatomical repositioning without any tooth extraction. Conclusion: This case demonstrates that anatomical repositioning can be achieved with good esthetic, functional, and periodontal results through careful treatment planning, the use of light orthodontic forces, and tight anchorage control.