Management of an infectious complication appearing in a transcanine implant: a case report

Maxillary canine impaction is the second most common dental eruption anomaly, affecting approximately 0.2-3% of individuals, with a higher incidence in females. This condition often results in complications such as the misalignment of adjacent teeth, root resorption, and the development of cystic lesions. In some cases, abstention is recommended for impacted canine is kept with the lacteal tooth held on the dental arch. But in the longer term an implant therapy is nevertheless indicated.

A 42-year-old man presented with persistent swelling and pain in the maxillary region associated with a transcanine implant placed one year ago by his dental practitioner. Imaging assessment showed the implant's apex inserted into the impacted canine which presented a crown and root resorption and was associated to a radiolucency around. In order to preserve implant and reduce morbidity related to a full extraction of the tooth, a coronectomy was performed allowing inflammatory surrounding tissues curettage.

This case shows an infectious complication of a transcanine implant and demonstrates an approach for managing these complications while preserving this implant. The coronectomy is a less invasive technique that reduces potential surgical complications and supports healing. A 2-year follow-up revealed complete bone reossification reinforcing the effectiveness of this method in similar clinical scenarios.

This case suggests that coronectomy may be a viable option for managing impacted canines in proximity to implants when complete extraction poses a high risk of complications. However, given the limited number of reported cases and the absence of long-term data, this approach should be considered with caution. Further studies are necessary to better define the indications, long-term outcomes, and potential risks of this technique.