Maxillary Bilateral Canine-Premolar Transposition: A Rare Condition

Case Report

J Dent & Oral Disord. 2017; 3(3): 1061.

Maxillary Bilateral Canine-Premolar Transposition: A Rare Condition

Agarwala P¹, Agarwal V¹, Rekhade R¹ and Kulshrestha R²*

¹Department of Orthodontics and Dentofacial Orthopaedics, Haldia Institute of Dental Sciences & Research, India

²Consulting Orthodontist, Private Practice, Mumbai, India

*Corresponding author: Rohit Kulshrestha, Consulting Orthodontist, Private Practice, Mumbai, India

Received: March 28, 2017; Accepted: May 11, 2017; Published: May 18, 2017


Tooth transposition is very rare developmental phenomena in which the adjacent teeth are switched or have their positions changed with one another and due to this aesthetical and functional problem may be present. The maxillary permanent canine is the tooth most frequently transposed, and it is often transposed with the first premolar followed by the lateral incisor and lastly the central incisor in very rare cases. Several etiologic factors may lead to transposition like genetics, developing tooth buds displacement, mechanical interferences, trauma and early loss of incisors. This paper reports a case of bilateral transposition in the maxillary arch involving the first premolar and canine.

Keywords: Ectopic eruption; Maxillary canine; Tooth transposition


Tooth transposition is defined as the positional interchange in spatial area of two adjacent teeth including their roots, or eruption and development of a tooth in a position normally occupied by a non adjacent tooth. Tooth transposition can be a peculiar type of ectopic eruption in which the eruption order of teeth is changed [1]. It has been reported that transposition of maxillary teeth occurs approximately in one out of four hundred orthodontic patients. Transposition between the canine and first premolar (70%) is seen in maxillary dentition, followed by canine and lateral incisor (20%). Unilateral transpositions have been found more often than bilateral transpositions and it shows left side dominance [2]. In the literature, 6 types of transpositions have been clearly identified [3-5].

These are:

Several etiologic factors like genetics, change in position of developing tooth buds, mechanical interferences, trauma and early loss of incisors have been seen to be related to tooth transposition [4,6- 9]. This article presents the rare occurrence of bilateral transposition of maxillary canine with maxillary first premolar.

Case Presentation

A female patient aged 13 years reported to the Department of Orthodontics and Dentofacial Orthopedics Haldia Institute of Dental Sciences Haldia with a chief complains of irregular teeth. A clinical examination revealed Angle Class I occlusion with 1.5 mm of overjet and 3 mm of overbite (Figure 1). Further examination revealed interchanged positions between maxillary first premolar and canine on both right and the left sides (Figure 2). Upper left deciduous canine was still present and it showed decalcification on its labial aspect. Remaining teeth in all the other quadrants were at normal location with normal morphology, overjet and overbite. Orthopantomogram (OPG) and Lateral Cephalogram showed no abnormalities (Figure 3). Medical and family histories were taken and no relevant finding was seen. The patient did not give any history of tongue thrusting, nail biting or lip biting habit. Treatment options included extraction of maxillary premolars to create space for the transposed canines or distalization of maxillary molars along with the premolars to create space for mesial movement of the canines.