Precision Planning in Autotransplantation of Teeth by Using CBCT – An Effective Prosthetic Approach

Pitambar Shrestha

doi:10.3126/jnprossoc.v2i1.26831

Abstract

Auto transplantation can be considered a valid and predictable treatment option for rehabilitating patients with permanent teeth loss when a suitable donor tooth is present. Once thought to have unfavorable prognosis, auto transplantation has achieved high success rates and is an outstanding option for tooth replacement. This case report illustrates auto transplantation of a fully developed third molar in the place of a first molar with the guidance of CBCT (Cone Beam Computed Tomography).The added advantages of CBCT helps to make the process of auto transplantation more predictable, easier and less time consuming which will encourage many dental surgeons to add this treatment to their armamentarium.

Highlights

Autotransplantation or Autogenous tooth transplantation refers to transplantation of teeth from one site to another in the same individual, involving transfer of embedded or impacted or erupted teeth into extraction sites or into surgically prepared sockets.[1]This treatment is indicated in situations to manage congenitally missing teeth, movement of impacted or severely ectopic teeth, premature loss of permanent dentition, periodontal disease, endodontic failure, growing patient correcting discrepancies between arches and when a suitable donor tooth is available.[2, 3, 4]The first reported case of autotransplantation of teeth was in 1950s where third molars were autotransplanted into a first molar position,[5] since many articles have been published on this treatment modality
Predicting the prognosis for tooth autotransplantation is important for clinicians to identify the risks before surgery, and to help them plan the follow-up of such patients.[6]
K.et al suggested that two dimensional imaging is usually sufficient for radiographic planning of autotransplantation,[2] but when it comes to autotransplanting teeth with fully formed roots especially third molars, the authors suggest to use a three dimensional imaging technique (CBCT)

Summary

Introduction

Autotransplantation or Autogenous tooth transplantation refers to transplantation of teeth from one site to another in the same individual, involving transfer of embedded or impacted or erupted teeth into extraction sites or into surgically prepared sockets.[1]. Many practitioners are familiar with the techniques, these procedures have gained little place in the armamentarium of the general dentist despite its many advantages.[1] A successfully transplanted teeth can function like a totally normal teeth[6] and offers improved aesthetics, arch form, dentofacial development, mastication and speech and arch integrity.[4] The total cost of treatment is normally lower than other treatment modalities including dental implants, prosthetic restoration, and/or orthodontic space closure.[4,7] Formation of a functional periodontal ligament can aid with the continued eruption of the tooth, preservation of the volume of alveolar bone and arch form, as well as maintenance of proprioception to aid masticatory function.[8,9] This is a viable treatment option for replacing missing teeth, but as with any surgery, there are complications that can arise including pulpal necrosis, inflammatory and replacement resorption, poor periodontal healing and ankyloses.[8] These are complications that can be prevented or decreased by proper planning and following the right protocols. Figure 6: root canal of 48 showing the technique of holding the crown with a moist gauze piece

Discussion

Conclusions