1. MIGRATION AND TRANSMIGRATION: Report of 5 Cases
Yusuf Poyraz, Osman Sami Ağlarcı, Hasan Hüseyin Yılmaz
Sifa University Faculty of Dentistry Oral and Maxillofacial Radiology Department,Izmir,Turkey
Introduction
The term “transmigration” was first used by Ando et al in 1964 as migration of a tooth across the midline 1,2. The exact etiology of transmigration was not defined however a lot of factors were suggested by several authors. Some of these are premature loss or persistence of the deciduous teeth, genetics factors, crowding, supernumerary teeth and odontoma 3-4. The incidence of transmigration is reported % in literature 3. Transmigration is mostly seen in the mandibular canine. Transmigration is more often appeared in females than in males and often unilateral and symptomless5. Transmigrated mandibular canines was identified as the 5 types by Mupparapu 6. (Table 1)
There are several treatment options proposed for transmigrated teeth.These include:surgical removal, transplantation, exposure and orthodontic alignment, follow up without surgical intervention.The most common treatment option is prosthesis following the surgical removal 3.
Type1.
Mesially inclined impacted canine lying lingually or buccally to the lower anterior teeth, a certain part of the canine crown crosses the midline;
Type2.
The impacted canine lies below the apices of lower incisors close to the base of the mandible;
Type3.
The canine erupted mesially or distally when compared to the canine on the opposite side;
Type4.
The canine is positioned horizontally below lower premolars or molars on the opposite side, close to the base of the mandible;
Type5.
The canine is positioned vertically in the midline
Table1
Case1
A 28 year old male patient applied with a chief complaint of scaling and polishing. There were no systemic disease history according to clinical anamnesis. The intraoral examination revealed lacking of the lower left permanent canine. Panoramic radiography performed for radiological examination. Presence of a transmigrated left permanent canine that was positioned below apex of lower anterior teeth was detected on panoramic radiography(figüre 1) Hence there were no chief complaint clinically and no pathologic condition around the teeth radiologically, follow up was decided for patient
Figure1 g
Case 2
A 38 year old male patient applied with night pain in upper left second molar. Patient does not has sisytemic disease according to clinical anamnesis. In the panoramic radiograph it was detected microdontic migrated upper third molar into right maxillary sinüs.(figure2) Hence there were no chief complaint; follow up was decided for patient.
Case3
A 39 year old male patient applied with a chief complaint of pain in lower left second molar.There were no systemic disease history according to clinical anamnesis. Migrated upper left third molar was detected in the panoramic radiograph.(figure3) Follow up was decided for patient because there were no chief complaint clinically and no pathologic condition around the teeth radiologically.
Figure2
Case 4
A 23 year old female patient applied with pain in upper left second molar. Medical history was questioned and it was learned that there were no sisytemic disease.There were no teeth extraction according to dental history. The intraoral examination revealed lacking of all second premolars, and the lower left canine, reten­tion of the upper second left deciduous molar and the lower left deciduous canine. Radiological examination confirmed presence of a transmigrated lower left permanent canine,impacted upper canine and congenital missing of all second premolars .(figüre 4) There were no chief complaint clinically and no pathologic condition around the teeth radiologically. Follow up was decided for patient.
Figure3
Case5
A 20 year old female patient applied for dental check up. There were no systemic disease history according to clinical anamnesis. The intraoral examination revealed lacking of the lower left permanent canine. Radiological examination revealed the presence of a transmigrated left permanent canine that was positioned below apex of lower right anterior teeth and first premolar.(figüre 5) There were no chief complaint clinically and no pathologic condition around the teeth radiologically. Follow up was decided for patient.
Figure4
Figure5
CONCLUSION
Transmigration is a rare phenomenon that its exact etiology is not known yet 3-4. Although transmigration occurs mostly in mandibular cuspid teeth, it can occur rarely in other teeth3. In our case it was detected microdontic migrated third molar in maxillary sinüs.Although there are several treatment options proposed for transmigrated teeth the most common treatments are follow up or prosthesis following the surgical removal 5. Hence there were no chief complaint clinically and no pathologic condition around the teeth radiologically; follow up was decided for all patients
Rererences
1- Ando S, Aizawa K, Nakashima T, Sanka Y, Shimbo K, Kiyokawa K. Transmigration process of the impacted mandibular cuspid. J Nihon Univ Sch Dent. 1964;6:66–71.
2- U Aydin*, HH Yilmaz and D Yildirim. Incidence of canine impaction and transmigration in a patient
Population. Dentomaxillofacial Radiology (2004) 33,
3- Katarzyna Gruszka1, T. Katarzyna Różyło1, Ingrid Różyło-Kalinowska2, Katarzyna Denkiewicz1,Klaudia Masłowska1 Transmigration of mandibular canine – case report Pol J Radiol, 2014; 79:
4- Simon Camilleri, MSc, LDSRCS (Eng), MOrth RCS (Eng)a; Erica Scerri, BChDb. Transmigration of Mandibular Canines—A Review of the Literature and a Report of Five Cases. Angle Orthodontist, Vol 73, No 6, 2003.
5- Muhammed-Isa Kara 1, Sinan Ay 2, Ali-Murat Aktan 3, Ismail Şener 4, Cihan Bereket 4, Şeref Ezirganlı 5, Mehmet Demirkol Analysis of different type of transmigrant mandibular teeth. Med Oral Patol Oral Cir Bucal May 1;16 (3):e
6- Mupparapu M: Patterns of intraosseus transmigration and ectopic eruption of mandibular Cannes: review of literature and report of nine additional cases. Dentomaxillofac Radiol, 2002; 31: 355–60