Background: Tooth autotransplantation is defined as the surgical repositioning of an autogenous tooth in another surgical site within the same individual. Aim: The aim of this research was to analyze the outcome of tooth transplantation using immature donor teeth compared with closed apex teeth and to compare differences between donor tooth positions on the arch. Methods: Electronic and manual literature searches were performed in different databases, including the National Library of Medicine (MEDLINE), EMBASE (OVID), Cochrane Central (CENTRAL), and the digital library of the Universitat Internacional de Catalunya (UIC University) from 1978 to March 2021. Studies were selected when they fulfilled the following criteria: only human prospective clinical studies, minimum sample size of 10 patients, minimum follow-up of 1 year, studies reporting or with at least deducible data on survival rates, immediate tooth autotransplantation with completed or incomplete root formation, and publications in the English language. A meta-analysis of random effects was developed to estimate the global effect measure of the survival rate, success rate, and root resorption involving the total sample, as well as open- and closed-apex groups. Results: Twenty-four articles were eligible for analysis. The Cohen’s kappa corresponding to this review was 0.87, and the risk assessment was considered low–moderate for the included studies. Overall survival and success rates were 95.9% and 89.4%, respectively, with a mean follow-up of 4 years and an overall mean age of 25.2 ± 12.3 years. Closed apex teeth showed a survival rate of 3.9% lower than that of open apex teeth. Higher complication rates were found for both inflammatory external root resorption and replacement root resorption in the closed-apex group, without reaching statistical significance. Conclusions: Tooth autotransplantation is a viable treatment alternative, regardless of the apical condition, with high survival and success rates after a mean follow-up of 4 years. Open-apex donor teeth could be considered the gold-standard option, showing lower complication rates when compared to closed-apex donor teeth. Future randomized controlled clinical studies are needed to examine the long-term prognosis of this technique.
Background: Tooth autotransplantation is a valid method for replacing nonrestorable teeth. This study aimed to assess mid-term survival and success of autotransplanted third molars and the clinical periodontal parameters and factors predicting successful periodontal attachment apparatus regeneration. Methods: In total, 36 patients who had undergone extraction and subsequent autotransplantation of 36 third molars using virtual planning and computeraided rapid prototyping models by an oral surgeon and endodontist were eligible. Probing pocket depth (PPD), gingival recession (REC), clinical attachment level (CAL), pulpal and periapical healing, root resorption, and radiographic bone loss (RBL) were evaluated. Additionally, a questionnaire evaluated patient-reported outcomes. Results:The mean age of the participants was 30.2 years with a mean followup duration of 29.42 ± 14.56 months. The overall survival and success rates were 97.2% and 91.7%, respectively. No statistically significant differences were found in success and survival rates between open and closed apex groups or between compromised and intact buccal bone groups. No signs of pulp necrosis were found in the open apex group. Progressive replacement resorption was detected in one closed apex case. The mean PPD was 2.7 ± 0.45 mm for all transplanted teeth. REC was 0.13 mm higher in transplanted teeth than in previous hopeless teeth. CAL changes were neither clinically relevant (−0.17 ± 0.66 mm) nor statistically significant. The reported patient satisfaction was high.Conclusions: Autotransplantation of third molars is a predictable treatment method, with a 2.5-year cumulative tooth survival and success of 97.2% and 91.7%, respectively, which were not influenced by recipient site integrity or root development.
Introduction: Digital technology has been progressively introduced into tooth autotransplantation to enhance both treatment planning and surgery. The aim of this report was to describe a novel protocol for fully guided tooth autotransplantation. Methods: This report includes 10 consecutive patients treated with a complete virtual planning and a multidrilling axis surgical guide in combination with the computer-aided rapid prototyping model. Results: All transplanted teeth fulfilled the criteria for success over a mean follow-up duration of 13.1 months. No signs of progressive root resorption or pain were found during follow-up. One case required minimal adjustment of the surgical stent to allow correct seating, whereas a second case could not be performed fully guided because of limited mouth opening. Conclusions: Our protocol for fully guided tooth autotransplantation is a viable option that involves minimal bone preparation in a short surgical time. Future research should focus on further investigation of the benefits of this novel protocol in a larger sample.
Background: Trauma of developing teeth may lead to pulpal necrosis with subsequent arrestment of root development, making them more susceptible to fracture. Regenerative endodontic procedures induce maturogenesis in necrotic immature permanent teeth in order to promote continuation of root growth. Mineral trioxide aggregate (MTA) is widely used as a blood clot protecting material, although it presents a potential drawback of discoloration. Biodentine is a tricalcium silicate cement with adequate bioactive properties that solve the problem of discoloration. Case report: The current case report demonstrates a maturogenesis of an upper central incisor with chronic apical abscess. Calcium hydroxide was used as intracanal medicament for a week. After a blood clot was formed, Biodentine was placed over it. Periapical healing and root growth were evident at 6 months follow-up. Cone Beam Computed Tomography (CBCT) confirmed apical closure and complete healing at 1 year. Key-learning points: Apical closure of necrotic immature permanent teeth is possible by means of regenerative endodontic procedure.Regenerative endodontic procedure with Biodentine has some advantages over that performed with MTA: No tooth discoloration, hort setting time, asy manipulation. CBCT is the best technique to evaluate root canal growth (length and wide).
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