In some cases, attempting to orthodontically reposition a retained canine may have little chance of success and is associated with high risk of compromising adjacent elements’ health. In these cases in which the risks exceed the possible benefits and the orthodontist decides for an extraction with relative replacement of the element with an osseointegrated implant, it is necessary to take into account the autotransplant. The review of the literature in this regard tells us that in the case of immature apex the success rate of an autotransplant is greater than 90% and with ample possibility of reconnection of the vascular circulation and sometimes, as in this case, also of the nerve bundle with restoration of the sensitivity as well as vitality. In this case the canine is positioned horizontally with part of the crown placed palatially at the root of the central incisor and in its anomalous eruption path has determined the complete resorption of the apex of the adjacent lateral incisor. After all the necessary evaluations, it is decided to extract and reimplant the canine in its natural position in place of the respective deciduous tooth still in the arch. To facilitate the creation of the new alveolus, an exact copy of the canine in resin-coated alabaster plaster (light blue) is built with a 3D printer to avoid using the tooth itself as a model for creating the new alveolus. 12 months after the operation, the canine has almost finished its apicification and is surrounded by a healthy periodontium, (as shown radiologically) no probing is present and vitality and sensitivity are restored.
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