Dentigerous cyst associated with mandibular transmigration and the presence of a supernumerary tooth. Presentation of a clinical case.

Abstract

Introduction: Dental transmigration is a rare anomaly characterized by the migration of more than half of the length of an impacted tooth across the midline of the maxilla or mandible. Its etiology is multifactorial and has been associated with genetic factors, developmental disturbances, and environmental conditions. Objective: To describe the diagnosis and surgical management of a case of mandibular canine transmigration associated with an odontogenic cystic lesion. Materials and Methods: A clinical case report is presented involving a 15-year-old male patient referred to the maxillofacial surgery service by orthodontics following an incidental radiographic finding. Clinical and imaging evaluations were performed using panoramic radiography, complemented by diagnostic studies, followed by surgical intervention and histopathological examination of the lesion. Results: Intraoral examination revealed absence of tooth 3.3 and persistence of the primary tooth 7.3, with swelling at the level of the mandibular symphysis. Imaging studies confirmed transmigration of the left mandibular canine (3.3), classified as type II according to Mupparapu, associated with a pericoronal radiolucent image compatible with a dentigerous cyst and the presence of a supernumerary tooth. Surgical extraction of the impacted tooth and biopsy of the lesion were performed, and histopathological analysis confirmed a dentigerous cyst. Postoperative evolution was favorable. Conclusion: Canine transmigration is an uncommon anomaly that requires early diagnosis and multidisciplinary management to prevent complications associated with tooth impaction and concomitant lesions. In this case, individualized and timely surgical treatment resulted in a favorable clinical outcome.