Posterior tooth autotransplantation: a case series

Abstract

Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Autotransplantation can provide a long-term, cost-effective and biological solution for adolescent patients with congenitally missing teeth or significantly compromised teeth when a suitable donor tooth is available. Successful autotransplantation of immature teeth can offer many advantages for a growing patient, including a normally functioning periodontium, proprioception and preservation of alveolar bone volume. Even in the event that an autotransplanted tooth does eventually fail, the bone and soft tissue conditions are likely to be conducive for subsequent implant treatment. Despite the significant physiological and cost-benefit advantages, tooth autotransplantation remains relatively underutilized, as the procedure is considered to be technique-sensitive. Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three-dimensional computed tomography and rapid prototyping have the potential to simultaneously reduce the technique sensitivity and increase the predictability of the autotransplantation procedure. It is hoped that this case series will provide greater awareness and an appreciation of the tremendous value of autotransplantation for the management of patients with congenitally missing or significantly compromised posterior teeth.

Management of a patient with a severely infraoccluded primary molar and hypodontia

“… 41 Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three‐dimensional computed tomography and rapid prototyping have the potential to significantly reduce the technique sensitivity of the autotransplantation procedure. 41 …”

“…41 Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three-dimensional computed tomography and rapid prototyping have the potential to significantly reduce the technique sensitivity of the autotransplantation procedure. 41 The patient in this case report was also considered to be a potential candidate for tooth autotransplantation. The left mandibular third molar (38) may have eventually become a reasonable donor tooth to replace the congenitally missing 35.…”

2-Year Follow-Up of Bilateral Immediate Autotransplantation: Case Report

“…11 Although there are many different treatment options in single tooth missing, autotransplantation has been applied frequently in recent years due to its low cost, ability to be applied in a single session and regaining proprioceptive functions. 2,12 Although autotransplantation has been applied procedure since the 1950s, the success rate remained at 50% due to the difficulties in determining the level of root growth, so root resorption was seen after transplantation. 5 The success rate in publications reported in recent years has reached 93%.…”

Autotransplantation of the Lower Posterior Teeth: A Comprehensive Review

“…To ensure predictable results, patients must be able to follow postoperative instructions and be available for follow-up visits; cooperation and understanding are essential factors of success. Most importantly, the recipient site and donor tooth must be suitable [28][29][30][31][32][33]. Guidelines for chosen transplant cases are demonstrated in Table 1.…”

“…For a successful autotransplantation, a number of recommendations have been suggested in previous studies [5,30], which include the following: patients should be healthy and medically fit, any infection at the host site should be controlled, postoperative supragingival plaque should be controlled, the donor site should have a normal morphology that should match the recipient site without any complications, half to three-quarters of root formation with an immature root apex (1-mm width of the open apex), atraumatic extraction (preserving bone and periodontal support), less than one minute of extraoral time for the donor tooth, donor tooth should be placed into a fresh extraction site (preferably arranged using a 3D surgical tooth template), adequate fixation (rigid splinting or increased time of fixation of the transplanted tooth can affect its healing outcome), periodontal healing normally accomplished after 7-8 weeks, the diagnosis can be made radiographically as the presence of lamina dura and a continuous space around the root with no root resorption, most transplantation trauma should be avoided, and excellent oral hygiene should be maintained.…”