Patterns of intra-osseous transmigration and ectopic eruption of mandibular canines: Review of literature and report of nine additional cases

Abstract

The purpose of this study is to (1). investigate the patterns of transmigration and eruption of permanent mandibular canines, plus the mechanisms affecting the eruption path, (2). classify the transmigration paths.
:A retrospective radiographic study using full mouth (FMX) and panoramic radiographs of dental radiology patients between July 1996 and July 2000. Transmigrated canines were identified from the radiographic records of 2150 new patients. The literature was reviewed regarding the individual patterns of canine transmigration and their final position within the mandible. A pattern classification was developed using literature data and the additional nine cases reported here.
In the present study, mandibular canines were found transmigrated on nine occasions and, in a further six cases, found impacted without transmigration. Out of the nine cases, seven were female (ages 17-38) and two were male (ages 20 and 69). One female patient had a bilateral transmigration of the mandibular canines. A total of 127 transmigrated canines were reported in 50 published studies from the literature. Transmigrated canines appear to fall into five patterns (Type 1-5) depending on their path of deviation. Type 1 was most common (45.6%) followed by Type 2 (20%), Type 4(17%), Type 3(14%) and Type 5 (1.5%).
Patterns of mandibular canine transmigration can be classified into five distinct patterns. The majority of cases demonstrated Type 1 transmigratory pattern. No clear aetiology of this disorder could be found.

Full text

RESEARCH
Patterns of intra-osseous transmigration and ectopic eruption of
mandibular canines: review of literature and report of nine
additional cases
M Mupparapu*
,1
1
University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
Objectives: The purpose of this study is to (1) investigate the patterns of transmigration and
eruption of permanent mandibular canines, plus the mechanisms aecting the eruption path, (2)
classify the transmigration paths.
Material and methods: A retrospective radiographic study using full mouth (FMX) and
panoramic radiographs of dental radiology patients between July 1996 and July 2000.
Transmigrated canines were identi®ed from the radiographic records of 2150 new patients. The
literature was reviewed regarding the individual patterns of canine transmigration a nd their
®nal position within the mandible. A pattern classi®cation was developed using literatu re data
and the additional nine cases reported here.
Results: In the present study, mandibular canines were found transmigrated on nine occasions
and, in a further six cases, found impacted without transmigration. Out of the nine cases, seven
were female (ages 17 ± 38) and two were male (ages 20 and 69). One female patient had a
bilateral transmigration of the mandibular canines. A total of 127 transmigrated canines were
reported in 50 published studies from the literature. Transmigrated canines appear to fall into
®ve patterns (Type 1 ± 5) depending on their path of deviation. Type 1 was most common
(45.6%) followed by Type 2 (20%), Type 4(17%), Type 3(14%) and Type 5 (1.5%).
Conclusions: Patterns of mandibular canine transmigration can be classi®ed into ®ve distinct
patterns. The majority of cases demonstrated Type 1 transmigratory pattern. No clear aetiology
of this disorder could be found.
Dentomaxillofacial Radiology (2002) 31, 355 ± 360. doi:10.1038/sj.dmfr.4600732
Keywords: tooth migration; transmigration; tooth, cuspid; tooth, impacted
Introduction
Although migration of teeth is a well-documented
ectopia, pre-eruptive migration of a tooth across the
midline of the jaw termed `transmigration', is a rare
phenomenon. There are currently at least 50 published
reports on canine transmigration with the ®rst reported
in 1951.
1
It is believed that transmigration is unique to
the mandibular permanent canines
2
as it has not been
reported for other teeth.
The aim of this study is to examine the path of travel
and eruption of all reported transmigr atory canines, to
describe the clinical and radiographic presentations of
these anomalous teeth, to compare the features of nine
new cases to exist ing cases and to classify the patterns
of transmigration of the mandibular canines.
Materials and method
Records of a total number of 2150 patients who
attended the Radiology clinics of our Dental School
between July 1996 and July 2000 were studi ed to
identify transmigrated mandibular canines. Records
were selected based on the presence of either a full
mouth radiogr aphic series (FMX) or a panoramic
radiograph with selected periapicals (PA) and bitewings
(BW). If patient records had any missing radiographs,
they were excluded from the study. Patient s' demo-
graphic information were obtained from the records.
*Correspondence to: Dr M Mupparapu, Depar tment of Oral Medicine, Division
of Oral and Maxillofacial Radiology, University of Pennsylvania School of
Dental Medici ne, 4001 Spruce Street, Philadelphia, PA 19104, USA;
E-mail: murali96@pobox.upenn.edu
Received 14 November 2001; revised 13 March 2002; accepted 12 June 2002
Dentomaxillofacial Radiology (2002) 31, 355 ± 360
ã
2002 Nature Publishing Group. All rights reserved 0250 ± 832X/02 $25.00
www.nature.com/dmfr

Table 1 Clinical and radiographic features of transmigrated mandibular canines observed in the present series of nine patients
Patient Position of the Eruption Primary Associated
number Age Sex transmigrated canine status canine pathology/remarks
1 17 F Positioned mesio-angularly labial
to the incisors. Crown crossing the
midline (Type 1)
Impacted CR None
2 20 M Positioned mesial to the opposite canine
(Type 3)
Impacted CE None
3 22 F Horizontally positioned near the lower
border apical to incisors (Type 2)
Impacted CE None
4 19 F Positioned horizontally at the lower
border below the apices of premolars
on the opposite side (Type 4)
Impacted CR Compound odontoma
5 30 F Positioned mesio-angularly near the
incisors, crown crossing the midline
(Type 1)
Impacted CE None
6 26 F Bilaterally crossing midline below incisor
apices (Type 1)
Impacted CR-1
CE-1
None
7 69 M Midline position enveloped in a cystic
lesion (Type 5)
Impacted Edentulous Large dentigerous cyst
8 19 F Midline eruption of canine (Type 5) Erupted CR Tooth rotated
9 21 F Midline eruption of canine (Type 5) Erupted CE Tooth rotated
CE=primary canine exfoliated; CR=primary canine retained; F=Female; M=Male
Table 2 Chronological listing of cases and data for transmigrated mandibular canines
Study
Author/s Year T Uni/Bi
Erupted or
impacted
Retained
primary Sex-Age
Type
I
Type
II
Type
III
Type
IV
Type
V
Associated
anomalies
1 Bluestone 1951 2 Uni NR NA Dentigerous
cyst
2 Thoma 1952 1 Uni I NR NA 1 None
3 Caldwell 1955 1 Uni I NR F-31 1 None
4 Bruszt 1958 2 Uni E CE F,M-NA 2 None
5 Stafne 1963 1 Uni I NR NA 1 None
6 Ando et al 1964 1 Uni I CE M-8 1 None
7 Kaufman et al 1967 1 Uni E NR F-19 1
8 Fiedler and Alling 1968 1 Uni I CR F-16 1 None
9 Pratt 1969 1 Uni E CR M-19 1 None
10 Pindborg 1970 2 Uni I CR M-15
11 Tarsitano et al 1971 3 Uni I CR-2 M-NA 2 1
CE-1
12 Heiman 1973 1 Uni I CR F-30 1
13 Wechsler 1973 1 Uni I NR F-12
14 Black and Zallen 1973 1 Uni I CR M-23 1 None
15 Miranti and Levbarg 1974 1 Uni I CR F-17 1 None
16 Grenberg and Orlian 1976 1 Uni I NR M-8 1 Dentigerous
cyst (1)
17 Howard 1976 8 Uni I CR-2
CE-6
M(2)
12-13
F(6)11-20
5 1 2 None
18 Barnett 1977 1 Uni E labial CE F-24 1 None
19 Cowman and Wootton 1979 1 Bi I CR-2 M-16 2 None
20 Abbot et al 1980 1 Uni E CR F-62 1 None
21 Hebda et al 1980 1 Uni I NR M-21 1 None
22 Zvolanek et al 1981 1 Uni I NR M-31 1 None
23 Joshi et al 1982 1 Bi I CR-1 M-19 2 None
24 Shapira et al 1982 3 Uni E-1 NR M-11 2 1 Odontoma (1)
25 Kerr 1982 1 Uni I CR F-9 1
26 Sofat 1983 1 Uni E CR M-20 1
27 O'Carroll 1984 1 Uni I CR F-28 1 Complex
odontoma
28 Vascova et al 1984 1 Uni I CR NA-14 1 None
29 Barsley 1984 1 Uni I CR F-24 1 None
30 Nashashibi et al 1984 2 Uni I NR M-19,
24
11
31 Javid 1985 13 8 Uni
3Bi
I CR-9
CR-1
NR-3
F(8)13-52
M(5)17-33
3 Infected
Dentigerous cyst(1)
chronic intraoral
fistula(2)
Continued
Canine transmigration
MMupparapu
356
Dentomaxillofacial Radiology

Canines were considered transmigrated if the path of
eruption had been altered and the tooth drifted to the
opposite side of the mandible with at least half the
length of the crown crossing the midline. Observations
were made on the number and status of missing
permanent mandibular canines; retained deciduous
canines; transmigratory pattern of canines and any
other associated pathology (Table 1).
A literature search was made of all reported
transmigrated cases of mandibular canines and added
to the new case reports. The total number of cases in
each study, position and transmigration status
(unilateral or bilateral), the gender and the age of the
patients and any associated pathology were recorded
(Table 2).
The following criteria were used to describe
transmigration patterns: inclination of the long axis
of the canine, relationship of the canine and, in
particular, the crown with the midline, adjacent teeth
and contralateral erupted canine. The transmigrated
teeth were classi®ed (Types 1 ± 5) based on their
migratory pattern and the ®nal position within the
jaw when diagnosed. The following criteria were used
to classify the transmigrated canines.
.
Type 1: Canine positioned mesio-angul arly across
the midline within the jaw bone, labial or lingual to
anterior teeth, and the crow n portion of the tooth
crossing the midline.
.
Type 2: Canine horizontally i mpacted near the
inferior border of the mandible below the apices
of the incisors
.
Type 3: Canine erupting either mesial or distal to
the opposite canine
.
Type 4: Canine horizontally i mpacted near the
inferior border of the mandible below the apices
of either premolars or molars on the opposite side.
.
Type 5: Canine positioned vertically in the midline
( the long axis of the tooth crossing the midline)
irrespective of eruption status.
Table 2 Continued
Study
Author/s Year T Uni/Bi
Erupted or
impacted
Retained
primary Sex-Age
Type
I
Type
II
Type
III
Type
IV
Type
V
Associated
anomalies
32 Jalili 1986 1 Bi I CE-1 M-16 1 1 None
33 Zvolanek 1986 1 Uni I NR F-25 1
34 Dhooria et al 1986 3 Uni I NR F-17
M-19,22
2 1 None
35 Gadgil 1986 1 Bi I CR-2 M-26 2 Impacted
23,24,25,26
apart from
canines
36 Mehta et al 1986 1 Bi I CE F-19 2
37 Broadway 1987 1 Uni I CR F-15 1 None
38 Gadalla 1987 1 Uni E CE F-22 1 Crown
erupted
39 Ripari et al 1988 1 Uni I CR M-9 1 Extra-orally
40 Vichi Franchi 1991 15 14
Uni1
Bi
I-14
E-1
CR-11
CE-4
F(11)10-42
M(4)9-13
11 1 1 2
41 Shanmuhasuntharam
and Boon
1991 2 Uni I NR F-20
M-52
1 1 Compound
42 Mitchell 1993 1 Uni I CR M-13 1 None
43 Brezniak 1993 1 Uni I CR F-19 1 None
44 Joshi et al 1994 2 Uni I CR-1
CE-1
F(2) 14 1 1
45 Wertz 1994 4 Uni I CR-3
CE-1
M(2) 12-13
F(2)9,
12
4 Cyst(1)
46 Karbanda and
Choudhury
1994 2 Uni I NR M-11
F-12
11
47 Kuftinec et al 1995 1 Bi I CE NA 2
48 Al-Waheidi 1996 5 2 Bi
3 Uni
I CR-3
CE-1
NR-2
F(5) 9-20 2 3 Dentigerous
cyst
49 Costello et al 1996 2 Uni F-19
M-33
11
50 Alaejos-Algarra
et al
1998 6 5 Uni
1Bi
I CR-1
NR-5
F(1) 28
M(4) 16-28
3 3 None
51 Joshi 2001 28 24
Uni
4Bi
I-23
E-1
CR-22
CE-10
F(18)9-23
M(10)11-22
11 4 9 4 Odontoma(1)
Total number of impacted
canines
127 59 26 19 22 2
T=Total number of cases reported; Uni/Bi=Unilateral/bilateral; NA=not available; CR=Retained primary canine; CE=Exfoliated primary
canine; NR=status not reported; F=Females; M=Males; E=Erupted; I=Impacted
Dentomaxillofacial Radiology
Canine transmigration
M Mupparapu
357

A scheme of the canine position for each Type is
depicted in Figure 1.
Results
A total of nine patients (Table 1) had transmigrated
canines with seven in females (ages 17 ± 38 ) and two in
males (ages 20, 69). Three canines migrated from the
left side, two from the right, one was bilateral and
three were in the midline. Four patients had retained
primary canines and the rest exfoliated primary
canines. In the three midline cases, the canines were
rotated on their long axes. One canine was impacted in
the midline of the mandible enveloped in a large cystic
lesion (Figure 2). The other two erupted into the oral
cavity in the midline (Figure 3). The rest of the
transmigrated canines were in varying stages of intra-
osseous travel and positioning within the mandible
(Figure 4 and 5). Out of the nine cases in the present
study, three canines exhibited Type 1 transmigratory
pattern (33%), Types 2, 3 and 4 had one each (11%),
and three of the canines were classi®ed as Type 5
transmigration (33%). The analysis of the data from
the literature (Tab le 2) showed that out of 127 reported
canine transmigrations worldwide, 58 teeth ®t into the
criteria for Type 1(45.6%), 26 into Type 2 (20%), 19
Figure 1 Diagramatic representation of the ®ve distinct patterns of
transmigration Types 1 ± 5. Retained deciduous tooth (tooth #83) is
also represented in the schematic
Figure 2 Transmigrated mandibular canine in the midline enveloped
in a large cystic radiolucency
Figure 3 Periapical radiograph showing transmigrated mandibular
left canine to the midline
Figure 4 Impacted, transmigrated left mandibular canine seen at the
lower border of the mandible below the apices of right mandibular
premolars on a cropped panoramic radiograph. Notice the retained
deciduous canine and an odontoma apical to it
Dentomaxillofacial Radiology
Canine transmigration
MMupparapu
358

into Type 3(14% ), 22 into Type 4(17%) and only two
in Type 5 (1.5%). The majority of the patients had a
retained deciduous tooth at the time of diagnosis of
this condition.
Discussion
Transmigration of mandibular canines is a rare
phenomenon with the review of the literature
1±55
showing only 127 instances (Table 2). The canines
were bilaterally transmigrated in at least 14 instances
among 10 published reports.
3±12
It has been repo rted
that impactions of maxilla ry canines are 20 times as
high as mandibular cuspids.
13
In early reports, a precise de®nition of transmigra-
tion, in terms of tooth pos ition, was lacking, leading to
spurious case reports.
14
Javid
5
suggested that a too th be
classi®ed as transmigrated when more than half of the
length of the tooth had passed the midline. Among the
nine cases from this series, migration of canines to the
midline occurred on three occasions, all these canines
crossing the midline lengthwise, hence qualifying to be
included in the classi®cation. To date this classi®cation
has not been applied in the published literature. In the
majority of the cases, the path of travel was horizontal
and not vertical. Hence it is pro posed that if a canine
reaches and crosses the midline lengthwise, it could still
be considered a true case of transmigration irrespective
of its eruption status.
A factor for consideration in the study of
transmigrated mandibular canines is the degree of
eruption. The vast majority of the cases of transmigra-
tion are impacted and only a few erupted either in the
midline or on the contralateral side (Table 2),
in¯uenced by degree of tilt, eruptive force and
obstructions.
In the present study, one midline canine (Type 5)
was enveloped in a large pericoronal cyst (Figure 2).
Whether the canine has previously migrated before
being caught up in the cystic changes or if the cystic
changes have indeed, in¯uenced the migration of the
canine is quite dicult to judge.
A transmigratory pattern classi®cation is desirable to
group all the reported cases and for the ease of further
studies on this topic. Type 1 was the most common
transmigratory pattern to be reported in the literature
and the present study also showed a Type 1
domination among the cases encountered. Type 5 had
the least number of cases in the literature whereas three
out of nine cases presented here were Type 5. This
discrepancy might be related to the small number of
cases in this personal series.
In conclusion, the transmigration of mandibular
canines could occur in any of ®ve distinct patterns
and midline eruption of these teeth (Type 5) is a
rarity among them. No common etiology was found
among the cases reported from the literature and
the cases presented here. Categorization of the
transmigratory patterns of canines in the future
studies may lead to a better understanding of this
rare anomaly.
Figure 5 Cropped panoramic radiograph showing the right
mandibular canine seen transmigrating to the left side. No associated
pathology is seen
References
1. Bluestone LI. The impacted mandibular bicuspid and canine:
indications for re moval and su rgical considerations. Dental
Items of Interest 1951; 73: 341 ± 355.
2. Cowman SC, Woott on WR. Bilateral impaction of mandibu lar
canines. NZDentJ1979; 75: 113 ± 114.
3. JoshiMR,DaruwalaNR,AhujaHC.Bilateraltransmigration
of mandibular canines. Br J Orthod 1982; 9: 57 ± 58.
4. Howard RD. The an omalous mandibular canine. Br J Orthod
1976; 3: 117 ± 121.
5. Javid B. Transmigration of impacte d mandibular cuspids. Int J
Oral Surg 1985; 14: 547 ± 549.
6. Jalili VP. Extreme medial and distal migration of mandibular
canines. J Indian Dent Assoc 1986; 58: 9.
7. Gadgil RM. Impacted mandibular anterior teeth. Oral Surg Oral
Med Oral Pathol 1986; 61: 106.
8. Mehta DS, Mehta MJ, Mrgesh SB, Thakur S. Impactions of
bilateral mandibular canines in criss-cross fashion. J Indian Dent
Assoc 1986; 58: 549 ± 551.
9. Kuftinec MM, Shapira Y, Nahlieli O. A case report: Bilateral
transmigration of impacted mandibular canines. JAmDent
Assoc 1995; 126: 1022 ± 1024.
10. Al-Waheidi EM. Transmigration of un erupted mandibular
canines: a literature review and report of ®ve cases. Quintessence
Int 1996; 27: 27 ± 31.
11. Alaejos-Algarra C, Berini-Aytes L, Gay-Escoda C. Transmigra-
tion of mandibular canines: report of six cases and review of
literature. Quintessence Int 1998; 29: 395 ± 398.
12. Joshi MR. Transmigrant mandibular canine s: a record of 28
cases and a retrospective review of the l iterature. Angle Orthod
2001; 71: 12 ± 22.
Dentomaxillofacial Radiology
Canine transmigration
M Mupparapu
359

13. Rohrer A. Displaced and impacted canines. Orthod Oral Surg
Int J 1929; 15: 1002 ± 1004.
14. Pindborg JJ. Pathology of the dental hard tissues. Philadelphia:
WB Saunders, 1970.
15. Ten Cate AR. Oral Histology: development, structure and
function. St Louis: Mosby, 1980.
16. Fiedler LD, Alling CC. Malpositioned mandibular right canine:
report of case. JOralSurg1968; 26: 405 ± 407.
17. Pratt RJ. Migration of canine across the mandibular mid-line.
Br Dent J 1969; 126: 463 ± 464.
18. Shapira Y, M ischler WA, Kuftinec MM. The displaced
mandibular canine. ASDC J Dent Child 1982; 49: 362 ± 364.
19. Peck S. On the phenomenon of int raosseous migration of
nonerupting teeth. Am J Orthod Dentofacial Orthop 1998; 113:
515 ± 517.
20. Stafne EC. Malposed mandibular canine. Oral Surg Oral Med
Oral Pathol 1963; 16: 1330.
21. Tarsitano JJ, Wooten JW, Burditt JT. Transmigration o f
nonerupted mandibular canines: report of cases. JAmDent
Assoc 1971; 82: 1395 ± 1397.
22. O'Carroll MK. Transmigration of the mandibular right canine
with de velopment of odon toma in its place. Oral Surg Oral Med
Oral Pathol 1984; 57: 349.
23. Hebda TW, Underwood AE. Transposed m andibular canine.
Oral Surg Oral Med Oral Pathol 1980; 50: 197.
24. Miranti R, Levbarg M. Extracti on of a horizontally transmi-
grated impacted mandibular canine: report of case. JAmDent
Assoc 1974; 88: 607 ± 610.
25. Shapira Y, Kuftinec MM. Intraosseous transmigration of
mandibular c anines : r eview o f the literatur e and treatment
options. Compend Contin Educ Dent 1995; 16: 1014, 1018 ± 1020,
1022 ± 1024.
26. Wechsler MH. An unusual cuspid in impaction. J Can Dent
Assoc 1973; 39: 35 ± 46.
27. Thoma KH. Oral Surgery. 2nd ed. St Louis: Mosby, 1952.
28. Kerr WJS. A migratory mandibular canine. Br J Orthod 1982; 9:
111 ± 112.
29. Barnett DP. An unusual transposition. Br J Orthod 1977; 4: 149.
30. Broadway RT . A misplaced mandibular permanent canine. Br
Dent J 1987; 163: 357 ± 358.
31. Joshi MR, Shetye SB. Transmigration of mandibular canines: a
review of literatu re and report of two cases. Quintessence Int
1994; 25: 291 ± 294.
32. Vaskova Von J, Markova M. Extreme dystopie Von Eckzahen
oder Pramolaren im Unterkiefer bedingt durch intraosseale
Migration. Zahn-Mund-u Kieferheilkd 1984; 72: 673 ± 678.
33. Gadalla GH. Mandibular incisor and canine ectopia: a case of
two teeth erupted in the chin. Br Dent J 1987; 163: 236.
34. Greenberg SN, O rlian AI. Ect opic movement of an unerupted
mandibular canine. JAmDentAssoc1976; 93: 125 ± 128.
35. Wertz RA. Treatment of transmigrated mandibular canines. Am
J Orthod Dentofacial Orthop 1994; 106: 419 ± 427.
36. Zvolanek JW, Spotts TM, Kopperud WH. A transmigrated
mandibular cuspid. Dent Radiog Photog 1981; 54: 38±39.
37. Zvolanek JW. Transmigration of an impacted mandibular
canine. Ill Dent J 1986; 55: 86 ± 87.
38. Ripari M, Maggiore C, Perfetti G, Ferraro E. Intraosseous
migration of a retained mandibular canine. Attual Dent 1988; 4:
42 ± 45.
39. Shanmuhasuntharam P, Boon LC. Transmigration of pe rma-
nent mandibular canines: Case report. Aust Dent J 1991; 36:
209 ± 213.
40. Heiman GR, Biven G. Transmigrated or malposed mandibular
cuspid. Oral Surg Oral Med Oral Pathol 1973; 35: 567.
41. Kharbanda OP, Choudhury AR. Extreme transmigration of
mandibular cuspid: report of two cases. J Clin Pediatr Dent 1994;
18: 307 ± 308.
42. Nashashibi IA, Abu Shalhoub S. The transmigration of lower
mandibular canine. Odontostomatol Trop 1984; 7: 39 ± 43.
43. Abbott DM, Svirsky JA, Yarborough BH. Transposition of the
permanent mandibular canine. Oral Surg Oral Med Oral Pathol
1980; 49: 97.
44. Ando S, Aizaea K, Nakashima T, Sanka Y, Shimbo K,
Kiyokawa K. Transmigration process of impacted mandibu lar
cuspid. JNihonUnivSchDent1964; 6: 66 ± 71.
45. Black SL, Zallen RD. An unusual case of tooth migration. Oral
Surg Oral Med Oral Pathol 1973; 36: 607 ± 608.
46. Bruszt P. Neurological anomaly associated with extreme
malposition of a mandibular canine. Oral Surg Oral Med Oral
Pathol 1958; 11: 89 ± 90.
47. Caldwell JB. Neurological anomaly associated with extreme
malposition of a mandibular canine. Oral Surg Oral Med Oral
Pathol 1955; 8: 484 ± 487.
48. Dhooria HS, Sathawane RS, Mody RN, Sakard e SB. Transmi-
gration of mandibular canines. J Indian Dent Assoc 1986; 58:
348 ± 351, 357.
49. Kaufman AY, Buchner A. T ransmigration of mandibular
canine. Oral Surg Oral Med Oral Pathol 1969; 26: 405 ± 406.
50. Sofat JR. Maleruption of mandibular canine. JIndianDent
Assoc 1983; 55: 111 ± 112.
51. Barsley RE, Cade JE. I mpacted mandibular cuspid and late ral
incisor: report of an unusual case. JOralMed1984; 39: 165 ±
168.
52. Mitchell L. Displacement of a mandibular canine followi ng
fracture of the mandible. Br Dent J 1987; 163: 236.
53. Brezniak N, Ben-Yehuda A, Shapira Y. Unusual mandibular
canine transposition: a case report. Am J Orthod Dentofac
Orthop 1993; 104: 91 ± 94.
54. Costello JP, Worth JC, J ones AG . Transmigration of permanent
mandibular canines. Br De nt J 1996; 181: 212 ± 213.
55. Vichi M and Franchi L. The transmigration of the permanent
lower canine. Minerva Stomatol 1991; 40: 579 ± 589.
Dentomaxillofacial Radiology
Canine transmigration
MMupparapu
360