Autotransplantation of a Mandibular Third Molar: A Case Report with 5 Years of Follow-up

Abstract

This paper describes the autologous transplantation of a mandibular right third molar to replace the residual roots of the second molar in the same quadrant, preserving function and aesthetics. A 5-year clinical and radiographic follow-up was undertaken. After transplantation, the donor tooth received endodontic treatment and placement of calcium hydroxide, which was periodically replaced every 3 months until the filling of the root canals, totalizing a period of 1-year, when apical closure was confirmed. The tooth was in perfect functional and aesthetic conditions 5 years after beginning of treatment. Autotransplantation is a feasible option for replacing missing teeth when a donor tooth is available. The autotransplantation of a right mandibular third molar with compromised function and aesthetics to replace the residual roots resulting from coronal destruction due to extensive carious lesion of the second molar in the same quadrant was a viable treatment alternative.

Auto-transplantation of teeth: 2 case reports

“…In such condition, auto-transplantation provides feasible option, and it acts as 'biological prosthesis [8] . Silva et al (2013) reported a case of auto-transplantation with 5 years follow up, where a right lower second molar was successfully transplanted by an impacted third molar of same quadrant of a 19-year old female [9] . Kobayashi presented a successful case of auto-transplantation of a 50-year old male, where a maxillary third molar was transplanted for second molar of same quadrant.…”

Eficácia Do Transplante Dental Autógeno Como Opção De Tratamento De Perdas Dentárias: Revisão De Literatura

“…As principais indicações para a realização do TDA são dentes ectópicos, perda traumática, agenesias, condições patológicas, perdas precoces devido a cárie, fechamento de espaços ortodônticos; sendo a perda precoce do dente por cárie a mais comum 3,15,16,17 4.4 CONTRAINDICAÇÕES Segundo Verwiej et al 7 (2017) o procedimento é contraindicado em pacientes com má higienização bucal, doenças periodontais e ausência de um dente doador adequado. Falhas ou complicações nas técnicas cirúrgicas também podem comprometer o sucesso do tratamento 18,19,20 . Yoshino et al, 21 (2012), realizou um estudo retrospectivo de casos em que constatou algumas complicações que ocasionaram a perda do dente transplantado.…”

“…A técnica cirúrgica é simples, porém requer muito cuidado em sua execução para não haver futuras complicações. Seu planejamento deve ser criterioso e a execução deve ser realizada da forma mais atraumática possível a fim de não danificar o dente extraído e preservar o ligamento periodontal 3,18,28 . Além disso, o paciente mais jovem terá terceiros molares mais imaturos que possuem um ligamento periodontal mais espesso para suportar os procedimentos prejudiciais da extração.…”

Tooth autotransplantation: review of the relevant procedural aspects for the clinical success

“…If adequate sterility is maintained during apicoectomy and retrograde root lling, then orthograde endodontic treatment can be avoided or postponed [94]. Temporary root canals llings of calcium hydroxide may contribute to the healing process and further deposition of mineralized tissue due to the high pH level and antimicrobial properties [94,[103][104][105][106]. Endodontic treatment after transplantation supports higher survival of teeth in comparison with effects obtained after extraoral or preoperative endodontic treatment, because it helps to decreases the time interval between extraction and transplantation phases.…”