Management strategies for transmigrated mandibular canines: Two case reports and review of treatment options

Transmigration of canines, which refers to the repositioning of unerupted/erupted (mandibular) canines across the midline, presents challenges in dental practice. This phenomenon is rare, with an incidence ranging from 0.8% to 3.6%. Two case reports are presented, highlighting the management of transmigrated mandibular canines. A 23-year-old woman with protruding upper front teeth and transmigrated mandibular canines (Type 5 according to Mupparapu classification) was presented in Case Report 1. Treatment involved non-extraction in the maxillary arch, while two options were proposed for the mandibular arch: Removal of both primary canines with surgical exposure of transmigrated and impacted permanent canines either distalizing them to their ideal position or allowing them to erupt in their original position and then reshaping them. A 25-year-old man with transmigrated mandibular canine (Type 5) and spacing in the upper front tooth region were described in Case Report 2. Treatment included extracting the mandibular retained deciduous canine and creating space for the transmigrated canine. The treatment plan prioritized orthodontic alignment over surgical intervention due to patient preference and the rarity of Type 5 transmigration. Both cases underscored the importance of early detection and orthodontic biomechanics in managing transmigrated canines, preserving dental arch integrity, and optimizing facial esthetics and function. Understanding the various treatment options and considering patient preferences are crucial for achieving successful outcomes in transmigrated canine cases.