Autotransplantation of Teeth with Complete Root Formation: A Case Series

doi:10.1016/j.joen.2010.04.028

Journal of Endodontics

Volume 36, Issue 8, August 2010, Pages 1422-1426

https://doi.org/10.1016/j.joen.2010.04.028 Get rights and content

Abstract

Introduction

Autotransplantation is a viable option for treating missing teeth when a donor tooth is available. This retrospective study reports the success rate for the autotransplantation of 19 molars with complete root formation.

Methods

The study enrolled 19 patients (11 men and 8 women) in whom 19 molars were transplanted. The mean age was 38.5 years (range, 19-67). The transplanted third molars were stabilized with a silk suture or wire splint for 2 to 3 weeks. Root canal treatment of the transplanted teeth was performed before surgery in six patients and 1 to 2 weeks after transplantation in 13 patients. Postoperatively, the marginal and periapical conditions were examined clinically and radiographically.

Results

In 16 of the 19 cases, the outcome met the success criteria, for an 84% success rate.

Conclusions

In autogenous tooth transplantation, even if the donor tooth has complete root formation, a high success rate can be achieved if the cases are selected and treated properly.

Section snippets

Material and Methods

This study analyzed the medical records and radiographs of 19 patients (11 men and 8 women) in whom 19 molars with complete root formation were autotransplanted in the Departments of Conservative Dentistry and Oral and Maxillofacial Surgery of Seoul National University Bundang Hospital. The ages of the patients at the time of surgery ranged from 19 to 67 years with a mean age of 38.5 years (Table 1). All of the patients were in good health, and a routine examination found no systemic or local

Results

On radiographs taken immediately after the transplantation, the transplanted tooth was seen in a wide tooth extraction socket. Two weeks after the transplantation, the pain and tenderness had decreased although the tooth mobility was grade 3. One month after the transplantation, the morphology of the transplanted tooth and surrounding gingiva were similar to that of the adjacent teeth. Six months after the transplantation, the mobility of the transplanted tooth had stabilized at grade 1, and

Discussion

To increase the success rate of autogenous tooth transplantation, a healthy periodontal membrane should be present on the transplanted tooth and the root morphology of the tooth to be transplanted should be simple. In addition, infection should be absent in the recipient site, and during surgery, the extraoral period should be short and trauma should be minimized 1, 10, 11. The most important factor for the success of autogenous tooth transplantation is the vitality of the periodontal ligament

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Cited by (70)

OUTCOMES OF AUTOTRANSPLANTED THIRD MOLARS WITH COMPLETE ROOT FORMATION: A SYSTEMIC REVIEW AND META‐ANALYSIS
2023, Journal of Evidence-Based Dental Practice
Clear evidence is lacking regarding the outcomes of autogenous tooth transplantation (ATT) of third molars with complete root formation. The current review aims to explore the long-term survival and complication rates.
A comprehensive search was performed in December 2022 of the PubMed, Scopus, Embase, EBSCO, Ovid, Science Direct, and Web of Science databases. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered at the International Prospective Register of Systematic Reviews (CRD42022337659). The pooled survival, root resorption, and ankyloses rates were calculated. Subgroup analyses were performed to explore the effects of sample size and 3D techniques.
Twelve studies from 5 countries fulfilled the eligibility, with 759 third molars transplanted in 723 patients. Five studies reported 100% survival at 1-year follow-up. After excluding these 5 studies, the pooled survival rate was 93.62% at 1 year. The survival rate of 1 large sample study was significantly higher than that of small ones at 5 years. The complications of studies using 3D techniques were: root resorption 2.06% (95% CI: 0.22, 7.50) and ankyloses 2.81% (95% CI: 0.16, 12.22), compared to those without 3D techniques: root resorption 10.18% (95% CI: 4.50, 17.80) and ankyloses 6.49% (95% CI: 3.45, 10.96).
ATT of third molars with complete root formation is a reliable alternative for replacement of a missing tooth and has a promising survival rate. The use of 3D techniques can reduce complication rates and improve long-term survival.
Autotransplantation with tooth replica: Technical note
2023, Journal of Stomatology, Oral and Maxillofacial Surgery
Dental autotransplantation is a surgical procedure that involves the implantation of a tooth with incomplete root development to replace an injured or missing tooth. An initial surgery was performed to attempt orthodontic traction without success after 6 months.
Preoperative assessment included mandibular cone beam computed tomography to visualise two canines. The double autotransplantation technique was performed under general anaesthesia using three-dimensional resin-printed dental replicas. The extra-alveolar time for each tooth was reportedly <1 min, and pulp sensibility was observed 3 months later.
In the digital era, dental autotransplantation has become an essential part of orthodontic–surgical treatment in children and adolescents with dental agenesis or non-preservable teeth. The use of three-dimensional dental replicas printed from radiological data offers a reliable, reproducible, and valid therapeutic solution with an advantageous benefit/risk balance.
Autotransplantation of Maxillary Third Molar with Its Attached Buccal Cortical Plate Combined with a Connective Tissue Graft
2023, Journal of Endodontics
Tooth replacement often leads to insufficient vertical volume in the recipient socket bone. The aim of this novel report is to present a successful fully guided autotransplantation of a maxillary right third molar (tooth #1) with its attached buccal plate. The procedure was combined with a palatal connective tissue graft to reconstruct a buccal hard and soft tissue defect of an irreparable maxillary right first molar (tooth #3).
A 45-year-old man complaining of pain in tooth #3 came to the clinic. Tooth #3 was non-restorable due to an extensive caries and a vertical root fracture of the mesiobuccal root, leading to a total loss of the buccal cortical plate. Guided autotransplantation of tooth #1 was completed by using 3-dimensional surgical templates for implant burs and a 3-dimensional-printed replica. After positioning the donor tooth, the cortical plate was fixed to the recipient socket with osteosynthesis screws. A connective tissue graft was also harvested to increase the band of keratinized gingiva and the thickness of the buccal soft tissue. At 6-month follow-up, the screws were removed, showing excellent regeneration throughout the buccal area.
At 3-year follow-up, the transplanted tooth was asymptomatic, with a natural bone level and no signs of replacement or inflammatory root resorption.
The use of a donor tooth and its attached bone cortical plate combined simultaneously with a connective tissue graft appears to improve hard and soft tissues in a single procedure.
Reconsidering some standards in immediate autotransplantation of teeth: Case report with 2-year follow-up
2022, Annals of Medicine and Surgery
Dental autotransplantation (DAT) is that surgical procedure of extracting a tooth from one place (donor site) and transplanting it into another (recipient site) within the same individual. If successfully implemented, the treatment outcome will pose characteristics of a natural tooth rather than a dental prosthesis. This case report sheds light on the validity of this treatment option, and provides suggestions to reconsider some standards regarding its conventional protocols.
A 24-year-old female with no history of medical conditions presented with hopelessnon-restorable lower molars with clinical signs of chronic infection. Cone-beam computed tomography (CBCT) was used to check compatibility of her third molars for DAT. After clinical and radiographical examination, patient's consent to perform DAT of impacted upper right third molar to replace the lower right first molar was obtained. Based on patient's CBCT, an individual replica of the donor tooth was fabricated. Replica helped in pre-preparing recipient site to fit the dimensions of the donor tooth before being extracted and transplanted. The extraction socket was thoroughly debrided and irrigated to ensure the removal of any lesion or infection. Immediate DAT was carried out with minimal trauma to the transplant. Follow-up for 2 years showed functional transplant with uneventful healing of periodontal and pulpal tissues.
Some standards regarding DAT needs to be reconsidered. Routine prophylactic endodontic treatment is not necessary for every case of DAT even when transplanted tooth is mature. Immediate autotransplantation into an infected site can be successful if the recipient site is managed properly.
Retrospective Evaluation of Immediate Impacted Third Molars Autotransplantation After Extractions of Mandibular First and/or Second Molars With Chronic Periapical Lesions
2021, Journal of Oral and Maxillofacial Surgery
To evaluate the success rate of simultaneous autotransplantation of the immature impacted third molars with the guidance of computer-aided rapid prototyping (CARP) to the place of mandibular first or second molars with extraction indication due to the untreatable radiographic periapical lesions.
Twelve radiographically and clinically hopeless mandibular first or second molars with periapical lesions of 10 patients between the ages of 15 to 21 were included in this retrospective clinical study. Cone-beam computed tomography (CBCT) images were used to produce the CARP models of the donor impacted third molars. Following the extractions of the mandibular first or second molars with periapical lesions, sockets were curetted and prepared with proper burs until a suitable infraocclusal fit of the CARP models. The donor teeth were transplanted synchronously with their surgical extractions. Postoperatively patients were followed clinically and radiographically in the 3rd and 6th months and every 6th month thereafter for at least 18 months. Clinically, the mobility, periodontal plaque, bleeding on probing, percussion sensitivity, periodontal pocket, vitality, and occlusion, and radiographically, the root resorption, ankylosis, presence of lamina dura, and healing of periapical lesion were assessed.
By the end of 12th month, and thereafter, all transplanted teeth were in occlusion and functioning properly with no clinical or radiological signs of pathology. All of the autotransplantation cases involved in this clinical study were successful within a mean follow-up period of 20.4 months with the least one of 18 months.
Immediate autotransplantation of the immature third molars to the place of mandibular first or second molars with extraction indication due to the periapical lesion can be a proper treatment option for adolescent patients.
Guided Osteotomy and Guided Autotransplantation for Treatment of Severely Impacted Teeth: A Proof-of-Concept Report
2020, Journal of Endodontics
The aim was to present a novel surgical technique using virtually preplanned 3-dimensional (3D)-printed templates for guided osteotomies. These were to ensure atraumatic uncovering of a severely impacted donor tooth including guided drilling of the recipient alveolus followed by a secure autotransplantation procedure.
This report presents an autotransplantation procedure of a 14-year-old patient with a severely impacted second premolar and extensive contact to the roots of the adjacent teeth and the inferior alveolar nerve. Autotransplantation of the impacted premolar was virtually performed using modified methods from guided implant surgery in order to prefabricate 3D-printed templates with the aid of a fully digital workflow.
Satisfactory treatment could be achieved using surgical templates for guided osteotomies of the surgical access, guided drilling of the recipient site, and occlusal reference template ensuring autotransplantation in the appropriate 3D location of the graft. An atraumatic approach could be ensured with an extraoral time of 46 seconds by 1 fitting attempt; no injuries or altered sensation of the inferior alveolar nerve were present. A vital natural tooth could be observed.
This innovative technique uses for the first time a fully implemented digital workflow for guided osteotomies, guided drilling, and guided autotransplantation of a severely impacted tooth. 3D-printed templates could ensure a guided atraumatic approach and facilitate highly complex treatments by virtually implementing recommended guidelines in future autotransplantations.

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Case Report/Clinical TechniquesAutotransplantation of Teeth with Complete Root Formation: A Case Series

Abstract

Introduction

Methods

Results

Conclusions

Section snippets

Material and Methods

Results

Discussion

Br J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Surg

J Endod

Int J Oral Surg

Int J Oral Surg

Oral Surg Oral Med Oral Pathol

J Oral Maxillofac Surg

J Am Dent Assoc

J Endod

Case Report/Clinical Techniques
Autotransplantation of Teeth with Complete Root Formation: A Case Series