CLINICAL AND RADIOGRAPHIC OUTCOMES OF INTENTIONAL REIMPLANTATION OF IMPACTED MAXILLARY CANINES: A RETROSPECTIVE CASE SERIES WITH FIVE-YEAR FOLLOW-UP

Background:Management of impacted maxillary canines remains a significant challenge in oral surgery and orthodontics. Although surgical exposure followed by orthodontic traction is considered the standard treatment, certain cases present with severe displacement, unfavorable angulation, or suspected ankylosis, making orthodontic repositioning difficult or unpredictable. In such situations, intentional reimplantation may offer a biologically based alternative for preserving the natural tooth. Objective:To evaluate the clinical and radiographic outcomes of intentional reimplantation of impacted maxillary canines using standardized surgical and endodontic protocols. Materials and Methods:This retrospective case series included 24 patients treated between 2021 and 2025 for impacted maxillary canines with an unfavorable prognosis for orthodontic traction. All patients underwent atraumatic surgical extraction, extraoral endodontic treatment when indicated, immediate reimplantation, and semirigid splint stabilization. Clinical and radiographic follow-up assessments were performed from the immediate postoperative period to a maximum of 5 years. Outcome measures included tooth retention, mobility, periodontal health, root resorption, ankylosis, and functional integration. Results:All reimplanted canines remained functional throughout the available follow-up period, resulting in a 100% tooth retention rate. Clinical success, defined as functional stability without progressive root resorption, ankylosis, periodontal deterioration, or loss of function, was achieved in 22 of 24 cases (91.7%). Mild non-progressive external root resorption was observed in one patient (4.2%), while two patients (8.3%) demonstrated persistent Grade I mobility without functional impairment. No cases of infection, ankylosis, severe mobility, progressive root resorption, or tooth loss were identified. Radiographic evaluation demonstrated preservation of periodontal ligament space and stable alveolar bone support in the majority of cases. Conclusion:Intentional reimplantation of impacted maxillary canines may represent a viable tooth-preserving treatment option in carefully selected cases where orthodontic repositioning is not feasible or is associated with poor prognosis. Preservation of periodontal ligament vitality, atraumatic surgical handling, minimization of extraoral time, and appropriate postoperative stabilization appear to be critical determinants of favorable outcomes. Further prospective multicenter studies with larger patient cohorts are required to validate long-term predictability and identify prognostic factors influencing treatment success.