A Rare Case of Mandibular Canine Transmigration with Concomitant Severe Incisor Root Resorption: A Diagnostic Revelation

This case report presents a rare and extreme manifestation of a vertically impacted and transmigrated mandibular canine, highlighting its diagnostic challenges and destructive potential towards surrounding dentition.

A 17-year-old girl presented with pain in the lower front jaw. Examination showed a retained primary mandibular left canine, missing permanent canine, and pulpal exposure in the central incisors. OPG revealed the permanent mandibular left canine was impacted and transmigrated, with its crown located between the roots of the left central and lateral incisors. This unusual position led to significant external root resorption of the lateral incisor and primary canine, and mild resorption of the central incisors.

The retained primary canine was a key etiological factor. Advanced imaging was crucial for diagnosis and treatment planning, revealing the full extent of irreversible damage. The severity of root resorption and the deep, transmigrated position of the canine made surgical extraction the primary treatment choice, as orthodontic alignment was considered highly complex and contraindicated.

Mandibular canine transmigration, though rare, can cause severe root resorption. This case underscores the importance of early radiographic diagnosis and intervention when a permanent canine is missing and a primary tooth is retained. For severe cases with significant pathology, surgical extraction is often the necessary management to resolve infection and prevent further damage.

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