Abstract
IntroductionAuto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. However, little is known about the precise role of the periodontal membrane during this procedure. Therefore, we investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuro-epithelial relationship.Case presentationWe report a case of a 21-year-old Caucasian woman who underwent an auto-transplantation of two third molars. After two years, renewed progressive caries of the auto-transplanted teeth led to the removal of the auto-transplanted elements. The periodontal ligament was removed and studied with a light and transmission electron microscope.ConclusionIn this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention. We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following auto-transplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth. In order to minimalise the damage to the epithelial rests of Malassez, the extraction of the tooth should be as atraumatic as possible in order to provide an optimal conservation of the periodontal ligament which will be beneficial to the healing-process.
Highlights
Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars
In this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention
We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following autotransplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth
Summary
Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. We investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuroepithelial relationship. The periodontal ligament (PDL) is the dense fibrous connective tissue which connects the cementum-covered surface of the root with the alveolar bone [1]. Its main function lies in preventing damage to the dental tissues during mastication It consists, in part, of thick collagen bundles, called Sharpey’s fibers, that run from the alveolar wall into the cementum and are responsible for resisting the displacing masticatory forces. A histopathological examination revealed that the cyst was predominantly surrounded by granulation tissue the local presence of Malpighian epithelium could be found On the periphery it was surrounded by an inflammatory infiltrate which consisted mainly of lymphocytes, plasmocytes and neutrophilic polymorphonuclear cells. The outermost lining consisted of a dense compact connective tissue and no signs of malignant degeneration could be detected
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