Intraalveolar transplantation: (I) The use of autologous bone transplants in the periapical region

Abstract

Intraalveolar transplantation of teeth with unfavourable cervical root fractures were performed in 15 patients. The roots were surgically extruded on an average 4.5 mm, and autologous bone transplants were placed above the apical part to support the root. Temporary endodontic therapy was carried out before the transplantation in 10 patients and 3 weeks after transplantation in 2 patients. 3 of the teeth had old root fillings. Postoperative controls were made weekly during the first month, after 3 months, 6 months, 1 and 2 years. The roots had become stable in most cases after 3 weeks. The mobility grade was dependent on the extent of extrusion. Radiographic controls showed formation of a normal periodontal space around the roots after 3 months, but also minor root resorption in the most apical part in 10 of the cases. The resorption was, however, not progressive in nature and was limited to the apical part. Remodelling of the marginal bone contour around the transplanted roots was evident in 11 patients. Periapical destructions were found in 3 patients at the 2-year control. Crown therapy was carried out with due attention to the special prosthetic problems associated with preparation of small remaining root fragments with unfavourable crown/root ratio.