Successful immediate autotransplantation of immature maxillary third molar to rehabilitate grossly mutilated second molar: A 4-year follow-up case report

Abstract

Autotransplantation is a viable option for immediate rehabilitation of missing teeth in young patients. It aims to preserve pulp vitality and proprioception, aiding complete root formation and osseous development, resulting in esthetic outcomes. A 20-year-old healthy female patient presented with pain in relation to a grossly mutilated nonrestorable right upper second molar tooth. Due to the young age of the patient, the proposed treatment was autotransplantation of upper third molar with incompletely formed roots to rehabilitate the second molar. Following precise diagnosis and application of strictly standardized treatment protocols, the strategically chosen donor tooth was atraumatically extracted and transplanted into the recipient site causing minimal damage to the periodontal ligament cells (PDLs). Clinical and radiographic findings over the 4-year follow-up period demonstrated normal gingival healing along with gradual bone regeneration. There was continued root formation and pulp revascularization with subsequent partial pulp canal obliteration. Higher survival rates of transplanted teeth are significantly associated with strict case selection criteria and protection of PDL. An analysis of pertinent prognostic factors with a long-term follow-up is required to predict and improve the outcome of tooth transplantation.