Orthodontic pre-treatment prior to autotransplantation of palatally impacted maxillary canines: case reports on a new approach

Impacted maxillary canines in oblique horizontal positions may make orthodontic appliance treatment hazardous or impossible. Autotransplantation may be considered but the removal of the canine is often difficult and since atraumatic removal of the transplant is essential, autotransplantation is then impossible. A new possibility is orthodontic pre-treatment with distal and vertical traction of the impacted maxillary canine to bring the maxillary canine to a more favourable position and facilitate surgical removal and autotransplantation. Eight canines were surgically exposed and pre-treated prior to autotransplantation. Of 21 autotransplantations of maxillary canines, 20 were successful, among them all eight pre-treated cases. The orthodontic and surgical technique is described and illustrated in two case reports.