Autotransplantation of cryopreserved tooth in connection with orthodontic treatment

Abstract

In orthodontic treatment of certain cases of tooth loss, aplasia, or ectopia, autotransplantation is sometimes a valid treatment alternative and often provides an improved result, compared to conventional orthodontic treatment, if an appropriate donor tooth is available and the anatomic circumstances permit it. However, in some cases autotransplantation is not immediately possible as a one-step procedure. In such cases cryopreservation provides a clinically useful technique when an extraoral storage period of months or years is needed to orthodontically prepare the recipient region. In the present case a mature upper first left premolar was stored for 18 months. During this period sufficient space was achieved in the contralateral recipient region between the upper left first and second premolars. The thawed graft was autotransplanted to this position. Endodontic treatment was initiated 4 weeks after transplantation. Four years after transplantation, the periodontal healing of the grafted tooth appeared clinically and radiographically normal without any signs of root resorption. The presented case demonstrates the capacity of a cryopreserved tooth to regenerate what seems to be a normal periodontium after transplantation. If these findings are confirmed in further clinical trials, the technique could be a valuable tool in future orthodontic treatment planning.