Dental autotransplantation as a treatment alternative. A review of literature

Abstract

Background: The main problems in oral health are tooth decay and periodontal disease. These pathologies, if left untreated, trigger dental loss. Nowadays we have many treatments to replace dental loss, such as fixed prosthesis, removable prosthesis and dental implants. There is a NO-prosthetic alternative to the implant, tooth autotransplantation. The popularity of implants has led to the fact that transplantation has been overlooked as a treatment option. Aim/Hypothesis: The objective of this poster is to provide information and evidence about dental autotransplantation through a literature review in order to know its indications thoroughly, to discuss the different surgical or endodontic aspects of the current protocol, and its prognosis at short and long term. Materials and Methods: To carry out this work, a review of the literature was performed. A research of articles found in the electronic database of Medline PubMed, in the Cochrane Library and in the digital library of the International University of Catalonia (UIC) was carried out. Eight journals: Dental Traumatology, Endodontic topics, Journal of Endodontics (JOE), Japanese Society of Oral Implantology, Swedish Dental Journal, International Journal of Oral Surgery, European Journal of Endodontics, and Journal of Oral Rehabilitation were also included. This search included publications between the years 1970 and 2017. The keywords were: “tooth”, “dental” and “autotransplantation”. The keywords are registered and included in the MeSH terms of the NCBI. portal. Results: The initial search, using the keyword “tooth autotransplantation” in the electronic databases available, resulted in a total of 390 articles since 1970. All titles and abstracts were analyzed, discarding those that referred to another type of transplants, seeking agreement and relationship with the research topic. Finally 29 articles were included in this review. A total of 1393 autotransplants with open apex and 746 with closed apex are reported, of which 1232 and 597, respectively, were considered successful in a more than 1 year of follow-up. The overall success rate of autotransplants with open apex was 88.5% and that of closed apex was 80%, during a follow-up between 1 and 20 years. The percentage of total success of autotransplants of this review is 86.1%. Other aspects were evaluated: root formation, the splinting materials and the endodontic need. Conclusions and Clinical Implications: According to this literature review we can conclude that dental autotransplantation is a predictable treatment in the short and long term. Teeth with open apex show a success rate of 90.7%, while closed apex 80%. Autotransplantation with open apex presents a better short- and long-term prognosis than a closed apex, revascularizing and allowing full root development in its new alveolus. Closed apex autotransplants require root canal treatment to avoid possible pulpal and periodontal complications.