Immediate Tooth Autotransplantation with Root Canal Filling and Partially Demineralized Dentin/Cementum Matrix into Congenital Missing Tooth Region

Abstract

This clinical report describes immediate tooth auto-transplantation with an autograft of partially demineralized dentin/cementum matrix (pDDM), based on an orthodontic treatment plan for a 16-year-old male patient with a congenital missing tooth (#45). First, vital teeth (#14, #24) were extracted, and root canal filling (#14) was immediately performed with the support of a fixation device. Simultaneously, the tooth (#24) was crushed in an electric mill for 1 min, and the crushed granules were partially demineralized in 2% HNO3 solution for 20 min as the graft material. Next, the donor tooth was transplanted into the created socket (#45), and stabilized using an enamel bonding agent. The wet pDDM was loaded into the location of the congenital missing tooth, and the flap was repositioned. The bonding agent for stabilization was removed at 28 days, and also small contact points between the transplanted tooth and the upper premolar (#14) were added using photopolymerizable composite resin. X-ray photos were taken sequentially, and there were no postoperative complications. The radiographic images showed that the periodontal ligament space and alveolar ridge line could be observed at 18 months. The pDDM was harmonized with the mandible, and the remodeled bone-like shadow was observed in the graft region. We concluded that immediate tooth transplantation with root canal fillings and autogenous pDDM may be a valuable alternative to dental implanting or bridge formation for patients with a congenital missing tooth, followed by orthodontic treatment.

Demineralized dentin matrix for bone regeneration in dentistry: A critical update

“… Kim et al, 2023 Retrospective cohort N = 20 Socket preservation Immediate DDM Delayed DDM Collagen + bone 2.6–8.6 months Radiography; bone fill DDM resulted in higher bone fill than graft alone. Murata et al, 2022 Case report N = 1 Autotransplantation APDDM 18 months Radiography PDL space and alveolar ridge observed. Guided Bone Regeneration (GBR), Autogenous dentin demineralized matrix (ADDM), Cone-beam computed tomography systems (CBCT), autogenous partially demineralized dentin matrix (APDDM) and particulate cancellous bone and marrow (PCBM).…”

“…The literature search initially identified 23 studies (16 animal studies ( Copelli et al, 2021 , De Oliveira et al, 2013 , Elkady et al, 2023 , Fernandes et al, 2020 , Gomes et al, 2016 , Kabir et al, 2017 , Kim et al, 2021 , Kim et al, 2017 , Koga et al, 2016 , Ku et al, 2022 , Moraes et al, 2022 , Nam et al, 2016 , Qin et al, 2015 , Tanoue et al, 2018 , Um et al, 2016 , Zhu et al, 2021 ) and 7 clinical reports ( Kanazirski and Kanazirska, 2022 , Kim et al, 2022 , Kim et al, 2016 , Minamizato et al, 2018 , Murata et al, 2022 , Pang et al, 2017 , Umebayashi et al, 2020 ). These are summarized and critically appraised below in Table 1 , Table 2 .…”

“…Four of the clinical studies were case reports or case series ( Kanazirski and Kanazirska, 2022 , Kim et al, 2016 , Murata et al, 2022 , Umebayashi et al, 2020 ). One study reported on a randomized clinical trial ( Pang et al, 2017 ), one study was of a prospective cohort ( Minamizato et al, 2018 ) and another was a retrospective cohort study ( Kim et al, 2022 ).…”

“…Meanwhile, two studies described using DDM for sinus floor augmentation ( Minamizato et al, 2018 , Umebayashi et al, 2020 ). In one study, DDM was used to support autotransplantation ( Murata et al, 2022 ). No complications were reported in any study and all reported favorable clinical outcomes after application of autogenous DDM as a bone augmentation material ( Kanazirski and Kanazirska, 2022 , Kim et al, 2022 , Kim et al, 2016 , Minamizato et al, 2018 , Murata et al, 2022 , Pang et al, 2017 , Umebayashi et al, 2020 ).…”

Properties of Nanohybrid Dental Composites—A Comparative In Vitro Study

“…In the case of HU samples, the nanofiller particles are very well distributed in the polymer matrix, resulting in homogeneous and compact materials, and only some local filler clusters occur with rounded shapes and sizes of about 1 µm. The HU composite's uniformity and high finishing onto the smooth surface are reported in the literature [29,30] because of the nanoparticles' silanization, which facilitates the superficial wetting and subsequent composite compactness.…”