Oxidoreductase activity in the pulp of replanted and autotransplanted teeth in young dogs

doi:10.1016/0030-4220(81)90320-0

Oral Surgery, Oral Medicine, Oral Pathology

Volume 52, Issue 2, August 1981, Pages 205-209

Oral Surgery, Oral M...

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Abstract

The purpose of the present investigation was to assess the vitality of the pulp of replanted and autotransplanted teeth with incomplete root formation by means of histochemical demonstration of oxidoreductase activity during a 180-day period. Staining for enzyme activity was seen in the whole pulp during the first postoperative days. After 10 days, staining was observed only in the foraminal area of the pulp and in blood vessels in apparently necrotic tissue. Thirty days postoperatively staining was observed in the whole pulp; 180 days after replantation or autotransplantation six out of eight teeth exhibited enzyme activity in the entire pulp. Thus, it appeared that the pulp of the replanted and autotransplanted teeth with partly formed roots first underwent necrosis and that the dead tissue then was replaced by new tissue.

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Cited by (38)

Multimodal Imaging of Dental Pulp Healing Patterns Following Tooth Autotransplantation and Regenerative Endodontic Treatment
2023, Journal of Endodontics
Understanding the healing process of dental pulp after tooth autotransplantation (TAT) and regenerative endodontic treatment (RET) of immature teeth is important both clinically and scientifically. This study aimed to characterize the pattern of dental pulp healing in human teeth that underwent TAT and RET using state-of-the-art imaging techniques.
This study examined 4 human teeth, 2 premolars that underwent TAT, and 2 central incisors that received RET. The premolars were extracted after 1 year (case 1) and 2 years (case 2) due to ankylosis, while the central incisors were extracted after 3 years (cases 3 and 4) for orthodontic reasons. Nanofocus x-ray computed tomography was used to image the samples before being processed for histological and immunohistochemical analysis. Laser scanning confocal second harmonic generation imaging (SHG) was used to examine the patterns of collagen deposition. A maturity-matched premolar was included as a negative control for the histological and SHG analysis.
Analysis of the 4 cases revealed different patterns of dental pulp healing. Similarities were observed in the progressive obliteration of the root canal space. However, a striking loss of typical pulpal architecture was observed in the TAT cases, while a pulp-like tissue was observed in one of the RET cases. Odontoblast-like cells were observed in cases 1 and 3.
This study provided insights into the patterns of dental pulp healing after TAT and RET. The SHG imaging sheds light on the patterns of collagen deposition during reparative dentin formation.
Long-term Outcomes of Autotransplantation of Teeth: A Case Series
2019, Journal of Endodontics
Citation Excerpt :
Pulp healing is expected after transplantation of immature teeth12 (Figs. 1, 3, and 4). The healing is likely by revascularization27–29. Blood capillaries can invade the pulp canal through the large apical foramen, supplying nutrients to invading cells that will eventually fill the pulp space.
The aim of autotransplantation of teeth (ATT) is to replace a lost tooth with a functional tooth within the same patient. Although it has recently become more of a recognized and viable treatment approach in dentistry, the long-term outcomes are still not well-documented. The principal author (M.T.) has performed more than 1000 ATTs for reasons such as treating missing teeth, deep caries, poor endodontic results, and periodontitis over the past 30 years in private practice. During the course of private practice, 2 separate analyses were performed on a total of 319 cases with follow-up ranging from 2–26 years. The results showed a tendency toward higher success rates in younger patients; the success rate was highest in ATTs performed on immature teeth (about 95%), about 90% in patients younger than 30 years of age and approximately 80% in patients older than 30. The failures were most often caused by replacement resorption (ie, ankylosis-related resorption). The purpose of this case series was to show successful long-term outcomes of ATT as well as to provide clinical insights and describe tendencies noted over the course of 30 years of performing ATTs.
Virtual Simulation of Autotransplantation Using 3-dimensional Printing Prototyping Model and Computer-assisted Design Program
2018, Journal of Endodontics
Citation Excerpt :
These are favorable conditions for optimal pulp healing (20). Blood capillaries invade the pulp canal through the wide apical foramen supplying nutrition to cells that fill the pulp space (21). In the present case, the transplanted tooth (#17) did not respond to electrical pulp testing, whereas root development continued with a closed apex and the pulp canal was slightly obliterated (Fig. 4C).
This case report describes an innovative virtual simulation method using a computer-aided rapid prototyping (CARP) model and a computer-aided design (CAD) program for autotransplantation of an immature third molar.A compromised left mandibular second molar (#18) was extracted and replaced by autotransplantation using an immature left mandibular third molar (#17). In order to minimize the surgical time and injury to the donor tooth, a virtual 3-dimensional (3D) rehearsal surgery was planned. Cone-beam computed tomographic images were taken to fabricate the 3D printing CARP model of the donor tooth and tentative extraction socket. Subsequently, both CARP models were scanned with an intraoral scanner (CEREC Omnicam; Dentsply Sirona, Bensheim, Germany) followed by superimposition and virtual simulation of osteotomy preparation of the recipient alveolus using the CAD analysis program. During the surgery, the extraction socket was precisely prepared according to the predetermined location and dimensions via virtual simulation rehearsal surgery using CAD analysis. The donor tooth was atraumatically transplanted into the prepared socket. The follow-up examination revealed that the root developed with a normal periodontal ligament and lamina dura.Virtual simulation using a 3D printing CARP model and a CAD program could be clinically useful in autotransplantation of an immature third molar by ensuring an atraumatic and predictable surgery.
Influence of Extraoral Apicoectomy on Revascularization of an Autotransplanted Tooth: A Case Report
2018, Journal of Endodontics
Autotransplantation is considered a standard procedure with a poorer prognosis for mature than for immature teeth. In this case report, the root tip of an almost fully developed tooth was resected during autotransplantation to fit into a deficient recipient site. As a positive side effect, the apical foramen was enlarged, with potential improvement of the probability of revascularization. Clinical and radiologic follow-up examinations up to 18 months indicated revascularization and uneventful periodontal regeneration and thus successful autotransplantation. This case supports the hypothesis that intraoperative apicoectomy can improve the prognosis for revascularization of mature autotransplanted teeth. Further prospective controlled clinical studies are needed to confirm this innovative surgical approach.
Autotransplantation of immature third molars using a computer-aided rapid prototyping model: A report of 4 cases
2013, Journal of Endodontics
Citation Excerpt :
As a result of favorable clinical conditions, the HERS of the root cemental surfaces were not injured and were preserved around the apices (21). It is known that the HERS can organize the apical cells and provide nutrition by diffusion from the recipient site until revascularization under favorable conditions (15, 20) and can lead to continued root formation (22). Many studies have reported pulp regeneration in autotransplantation with immature teeth (9, 12, 13, 23–25).
Autotransplantation of immature teeth can be an option for premature tooth loss in young patients as an alternative to immediately replacing teeth with fixed or implant-supported prostheses. The present case series reports 4 successful autotransplantation cases using computer-aided rapid prototyping (CARP) models with immature third molars.
The compromised upper and lower molars (n = 4) of patients aged 15–21 years old were transplanted with third molars using CARP models. Postoperatively, the pulp vitality and the development of the roots were examined clinically and radiographically. The patient follow-up period was 2–7.5 years after surgery.
The long-term follow-up showed that all of the transplants were asymptomatic and functional. Radiographic examination indicated that the apices developed continuously and the root length and thickness increased. The final follow-up examination revealed that all of the transplants kept the vitality, and the apices were fully developed with normal periodontal ligaments and trabecular bony patterns.
Based on long-term follow-up observations, our 4 cases of autotransplantation of immature teeth using CARP models resulted in favorable prognoses. The CARP model assisted in minimizing the extraoral time and the possible Hertwig epithelial root sheath injury of the transplanted tooth.
The critical apical diameter to obtain regeneration of the pulp tissue after tooth transplantation, replantation, or regenerative endodontic treatment
2013, Journal of Endodontics
Regeneration of pulp-like tissue in the pulp chamber after tooth transplantation, replantation, or in regenerative endodontic treatment is only possible if the apical foramen is open. According to the literature, the success of regeneration decreases considerably if the foramen is smaller than 1 mm when measured on radiographs. The aim of this study was to study histologically the relation between the width of the apical foramen and regeneration of tissue in the pulp chamber after autotransplantation.
Fifteen single-rooted mature teeth of 3 adult beagle dogs were used. All experimental teeth were extracted and underwent apicoectomy. The teeth were photographed from the apical side, and the width of the foramen was calculated. The foramen width ranged from 0.24–1.09 mm. All teeth were replanted in infraocclusion. The observation period was 90 days after transplantation.
The 10 teeth with the smallest apical diameter, ranging between 0.24 and 0.53 mm, showed vital tissue in at least one third of the pulp chamber. The 6 most successful teeth showing vital tissue in the entire pulp chamber had an apical diameter between 0.32 and 0.65 mm, and 80% of the experimental teeth with a diameter varying between 1.09 and 0.31 mm showed vital tissue in at least one third of the pulp chamber 90 days after transplantation.
The size of the apical foramen seems not to be the all decisive factor for successful revascularization and ingrowth of new tissue after transplantation. The minimum width of the apical foramen has not been determined, but a size smaller than 1 mm does not prevent revascularization and ingrowth of vital tissue. In this animal study an apical foramen of 0.32 mm did not prevent ingrowth of new tissue in two-thirds of the pulp chamber 90 days after transplantation.

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^☆: This study was supported by grants from the Faculty of Odontology, University of Lund, Sweden.

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Oxidoreductase activity in the pulp of replanted and autotransplanted teeth in young dogs☆

Abstract

Oral Surg

Dent. Clin. North Am

Oral Surg

Oral Surg

Oral Surg

Autotransplantation of Teeth: A Clinical and Experimental Investigation

Acta Odontol. Scand