Autogenous Tooth Transplantation Research Articles

Combined application of artificial bone powders and concentrated growth factor membranes on the autotransplantation of mature third molars: A 5‐year retrospective case series

AbstractAimThis study aimed to observe the efficacy and outcomes of the combined application of artificial bone powder and concentrated growth factor (CGF) membranes for tooth transplantation in cases with wide recipient sockets and small donor teeth.Material and MethodsA total of 36 teeth from 36 patients with wide recipient sockets and small donor teeth were enrolled. Autogenous tooth transplantation was performed using bone powders and CGF membranes. After transplantation, the visual analog scale (VAS) score, Landry Wound Healing Index, probing depth (PD), mobility, and gray value of the alveolar bone around the transplanted teeth were measured, and a patient satisfaction questionnaire was administered. All patients underwent clinical and radiographic examinations during follow‐up.ResultsThe VAS score of 16 (44.4%) cases after 1 week was 0, and 26 (72.2%) patients showed excellent gingival healing after 2–4 weeks. The PD of a few cases was deeper than 3 mm during the first month; however, returned to normal after 3 months. Although the majority of the transplanted teeth possessed mobility greater than grade I during the first month, the mobility gradually improved within 3 months. The gray value of the alveolar bone around the transplanted teeth, 1 year postoperatively showed no difference with pre‐operation (p > .05). During the mean follow‐up period of 42.7 months (range 20–72 months), 33 of the 36 transplanted teeth remained in situ without clinical or radiographic complications, with an overall success rate of 91.7%.ConclusionsAlthough the PD and mobility of the transplanted teeth were not ideal during the early stages of healing, most of the transplanted teeth had good clinical outcomes. In cases with large recipient sites accompanied by small donor teeth, autotransplantation of teeth using artificial bone powder combined with CGF membranes is a viable option and can lead to optimistic results with favorable success rates.

Autologous Transplantation Tooth Guide Design Based on Deep Learning

BackgroundAutogenous tooth transplantation requires precise surgical guide design, involving manual tracing of donor tooth contours based on patient CBCT scans. While manual corrections are time-consuming and prone to human errors, deep learning-based approaches show promise in reducing labor and time costs while minimizing errors. However, the application of deep learning techniques in this particular field is yet to be investigated. PurposeWe aimed to assess the feasibility of replacing the traditional design pipeline with a deep learning-enabled autologous tooth transplantation guide design pipeline. Study design, setting, sampleThis retrospective cross-sectional study used 79 CBCT images collected at the Guangzhou Medical University Hospital between October 2022 and March 2023. Following preprocessing, a total of 5,070 region of interest (ROI) images were extracted from 79 CBCT images. Predictor variableAutologous tooth transplantation guide design pipelines, either based on traditional manual design or deep learning-based Main outcome variableThe main outcome variable was the error between the reconstructed model and the gold standard benchmark. We used the third molar extracted clinically as the gold standard and leveraged it as the benchmark for evaluating our reconstructed models from different design pipelines. Both trueness and accuracy were used to evaluate this error. Trueness was assessed using the root mean square (RMS), and accuracy was measured using the standard deviation (SD). The secondary outcome variable was the pipeline efficiency, assessed based on the time cost. Time cost refers to the amount of time required to acquire the third molar model using the pipeline. AnalysesData were analyzed using the Kruskal–Wallis test. Statistical significance was set at p < 0.05. ResultsIn the surface matching comparison for different reconstructed models, the deep learning group achieved the lowest RMS value (0.335±0.066 mm). There were no significant differences in RMS values between manual design by a senior doctor and deep learning-based design (p=0.688), and the SD values did not differ among the three groups (p=0.103). The deep learning-based design pipeline (0.017±0.001 min) provided a faster assessment compared to the manual design pipeline by both senior (19.676±2.386 min) and junior doctors (30.613±6.571 min) (p<0.001). Conclusions and RelevanceThe deep learning-based automatic pipeline exhibited similar performance in surgical guide design for autogenous tooth transplantation compared to manual design by senior doctors, and it minimized time costs.

3D Printing Technology with Reverse Guide Design in Autogenous Tooth Transplantation: An in vitro Pictorial Report.

The success of autologous tooth transplantation depends on the activity of the periodontal ligament of the donor tooth. Its activity decreases with a longer exposure time. In order to reduce the exposure time of the donor tooth and quickly prepare the alveolar fossa highly matching with the donor tooth root, the clinical data of cone-beam CT (CBCT) was imported into Mimics 21.0 software in this study to obtain three-dimensional (3D) images of the jaw tissue structure. The images were used to extract the target area and select the target tooth. By analysing the information of the recipient region and the donor region, 3-Matic 13.0 software was used to implant the donor virtual into the target region, and restrictive personalised guidance was designed. Subsequently, the surgical guide template was printed by 3D printing technology, and the alveolar fossa was rapidly prepared in vitro. After the operation, the donor tooth was matched with the complete alveolar cavity using 3-Matic13.0 software. The depth deviation of the prepared alveolar cavity was measured within 2.0 mm, and the width deviation was about 1.0 mm. The maximum width deviation is 2.88 mm due to the tilt of the roots. With a high matching degree to the donor tooth root, it needs further and larger clinical studies. Key Words: CBCT,Tooth autotransplantation, 3D printing technology, Computer-aided imaging, Periodontal ligament.

Autogenous Transplantation of Teeth

Autogenous tooth transplantation, or autotransplantation, is the surgical movement of a tooth from one location in the mouth to another in the same individual. Despite current scientific evidence indicating that autotransplantation has favourable long-term survival rates, autotransplantation is still not generally regarded as mainstream practice outside of Scandinavian countries. Successful autotransplantation can offer many advantages in a growing patient, including a normally functioning periodontium, propriocepProponents of autotransplantation emphasize its ability to maintain and permit continuation of alveolar bone growth. A successfully transplanted tooth erupts with growth and can also be moved orthodontically. In the event that the autotransplantation eventually fails, the bone and soft tissue conditions would still be likely to be favourable for subsequent implant treatment.

Clinical Assessment of Immediate Autotransplantation of Mandibular Third Molars: An In Vivo Study.

Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients' teeth with developing alveolar bone because it uses the patient's own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar. In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed. Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption. Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.

OUTCOMES OF AUTOTRANSPLANTED THIRD MOLARS WITH COMPLETE ROOT FORMATION: A SYSTEMIC REVIEW AND META-ANALYSIS.

Clear evidence is lacking regarding the outcomes of autogenous tooth transplantation (ATT) of third molars with complete root formation. The current review aims to explore the long-term survival and complication rates. A comprehensive search was performed in December 2022 of the PubMed, Scopus, Embase, EBSCO, Ovid, Science Direct, and Web of Science databases. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered at the International Prospective Register of Systematic Reviews (CRD42022337659). The pooled survival, root resorption, and ankyloses rates were calculated. Subgroup analyses were performed to explore the effects of sample size and 3D techniques. Twelve studies from 5 countries fulfilled the eligibility, with 759 third molars transplanted in 723 patients. Five studies reported 100% survival at 1-year follow-up. After excluding these 5 studies, the pooled survival rate was 93.62% at 1 year. The survival rate of 1 large sample study was significantly higher than that of small ones at 5 years. The complications of studies using 3D techniques were: root resorption 2.06% (95% CI: 0.22, 7.50) and ankyloses 2.81% (95% CI: 0.16, 12.22), compared to those without 3D techniques: root resorption 10.18% (95% CI: 4.50, 17.80) and ankyloses 6.49% (95% CI: 3.45, 10.96). ATT of third molars with complete root formation is a reliable alternative for replacement of a missing tooth and has a promising survival rate. The use of 3D techniques can reduce complication rates and improve long-term survival.

Research Progress on the Prognosis Influencing Factors of Autogenous Tooth Transplantation

This paper summarizes the factors affecting the prognosis of autologous dental transplantation and improvement measures, so as to provide theoretical guidance for the further application of autogenous tooth transplantation in dental clinic, and thus improve the success rates and survival rates of autogenous tooth transplantation in the clinic.

Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months

Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.

Oral Rehabilitation in An Adult Patient with Oligodontia with Retained Deciduous Teeth by Immediate Implant Placement

In the treatment of patients with oligodontia, factors such as patient age, developmental stage, and number of missing teeth should be considered. If the number of missing teeth is less, the patient can be treated with minimally invasive treatments, such as remaining primary teeth, autogenous tooth transplantation, and orthodontic treatment. However, when the number of missing teeth is high, conventional treatment may be limited. In this case, after extraction of the deciduous teeth, implants can be placed in the edentulous area. We report a case of oral rehabilitation with orthodontic treatment, bilateral sinus floor augmentation, and immediate implant placement in a 20-year-old man with oligodontia. The treatment was succesful, and we achieved esthetically and functionally satisfactory outcomes.

Screening and analysis of prognostic factors of repairing single missing tooth by autotransplantation of teeth

Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (β=-2.812, P=0.049), alveolar bone height (β=1.521, P=0.020), donor time (β=-2.001, P=0.019), use of donor model (β=1.666, P=0.034) and initial stability (β=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.

Application of concentrated growth factor to autotransplantation with inflammation in recipient area

ObjectiveThe purpose of this study was to apply concentrated growth factor (CGF) to the transplanted area with inflammation, to observe the clinical effects of CGF on the inflammation area assisted by 3D printing technology.MethodsA total of 52 compromised mandibular first or second molar with chronic periapical lesions were transplanted with mature third molars. The patients were divided into CGF group (n = 26) and control group (n = 26) and transplanted into fresh extraction sockets with or without CGF. All the patients underwent clinical and radiographic examinations during the follow-up.ResultsAverage surgery and extra-oral time were 39 min (± 7.8) and 42 s (± 10.2). The success rates of CGF group and control group were 100% and 92.3% respectively. Most of the periapical lesions in CGF group healed completely within 3 months, which was significantly faster than control group. The initial stability of CGF group was better than control group immediately after operation, and the degree of pain in CGF group was lower than control group on the 1st and 3rd day after operation.ConclusionsThe application of CGF in recipient site with chronic periapical lesions can accelerate the regeneration of alveolar bone and the healing of inflammation, greatly shorten the healing period. Meanwhile, CGF help to reduce postoperative pain and reaction at the early stage of healing and increase the success rate of autogenous tooth transplantation (ATT). Additionally, the use of 3D printing model can greatly reduce the extra-oral time of donor teeth.

Experience summary of 11 patients undergoing autogenous tooth transplantation by using the undersized third molar as the donor tooth

AbstractAimTo explore the clinical effect of autogenous tooth transplantation with the undersized third molar as a donor tooth.Material and methodsThe general situation, donor tooth and recipient area, timing of the operation, intraoperative and post‐operative treatments and curative effect evaluation of 11 patients undergoing autogenous transplantation of the third molar were analysed retrospectively.ResultsA total of 11 patients undergoing autogenous tooth transplantation, including 4 males and 7 females, with an average age of (34.9 ± 7.5) years. Among the donor teeth, 8 were located in the maxilla and 3 in the mandible. In the recipient area, 7 affected teeth needed to be extracted because they could not be reserved, and 4 teeth had been extracted. The recipient area was located in the anterior area in 2 patients, the premolar area in 6 patients and the molar area in 3 patients. Six patients underwent simultaneous tooth extraction and autogenous tooth transplantation, 5 patients underwent two‐stage transplantation, and all patients underwent elastic fixation of the transplanted teeth. During the operation, 8 patients only underwent soft tissue preparation, 3 patients underwent soft and hard tissue preparation, and 4 patients underwent guided bone regeneration. All 11 patients underwent improved root canal treatment, of whom, 9 patients underwent crown restoration. The mean post‐operative follow‐up time was (24.82 ± 16.41) months, the success rate was 90.91% and the survival rate was 100%.ConclusionsThe third molar can be used as the donor tooth for autogenous tooth transplantation with a higher success rate.

Pre- and peri-operative factors influence autogenous tooth transplantation healing in insufficient bone sites

BackgroundThe amount of bone remaining at the transplant site for autogenous tooth transplantation can facilitate successful healing. Therefore, this retrospective study evaluated the factors influencing the healing of 50 successful autogenous tooth transplantations with insufficient bone support at the transplanted site without a bone graft.MethodsThe factors were classified as pre- and peri-operative factors, and the healing outcomes were clinical and radiographic observations. The factors were statistically analyzed using the chi-square test to identify correlations between the pre- and peri-operative factors and the clinical and radiographic outcomes. The T-test or one-way analysis of variance was used to compare the percent bone change in each factor.ResultsThe results indicated that gingival healing was delayed in the intra-arch transplantations, and pulp obliteration was seen earlier when transplanted in the maxilla. Patients under 18-years-old demonstrated a greater percent bone change than the over 18-year-old patients, while the peri-operative variables did not have a relationship with clinical healing and the amount of bone change over 12 months. Furthermore, the percent bone change significantly increased during the first three months.ConclusionsIn conclusion, pre-operative factors, age and transplant site, influenced the healing rate of autogenous transplanted teeth. In contrast, the peri-operative factors were not related with the clinical and radiographic outcomes. Generating the least trauma to the periodontal ligament cells is the most important concern.

Effect of Root Canal Therapy on the Success Rate of Teeth with Complete Roots in Autogenous Tooth Transplantation.

Background Autogenous tooth transplantation is a reliable method for repairing missing teeth. Although it recently became a recognized and feasible treatment method in dentistry, the long-term efficacy of root canal therapy (RCT) has not been well confirmed. This study is aimed at determining whether RCT has a good effect on the success rate of teeth with complete roots in autogenous tooth transplantation. Materials and Methods Data were collected from the Korea University Guro Hospital. Data of patients who underwent autogenous tooth transplantation within 9 years were collected. We selected 29 teeth with complete roots as the research subjects in our study. None of the patients had any systemic diseases. All cases in this study were obtained with patient permission. Results According to the tooth vitality test, the autogenous teeth tested negative in dental pulp test and function. Nine of the 29 teeth with autogenous tooth transplantation were treated with RCT and survived throughout the observation period. However, 20 autogenous teeth were not treated with RCT, and eight of them did not survive. All statistical analyses were performed using IBM SPSS 20.0. The null hypothesis was rejected (p < 0.05). Conclusion For complete root teeth, the success rate after autogenous tooth transplantation after RCT is higher than that of teeth not treated with RCT.

Clinical observation of three-dimensional printing donor tooth model in peri-operative period of autotransplantation of tooth

Objective: To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period. Methods: In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［107 males and 85 females, age (34.2±10.7) years］ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［28 males, 36 females, age (30.2±8.3) years］ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results: In part one, the coincidence rate between the second prediction and the actual results ［97.4%(187/192)］ was significantly higher than that of the first prediction ［93.2%(179/192)］ (P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (P<0.05). Conclusions: The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

The influence of storage temperature on fracture behavior of cryopreserved teeth-An in vitro study.

ObjectivesCryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long‐term prognosis of the teeth.Material and methodsTwenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at −80°C (group 1) and −196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load.ResultsNo significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests.ConclusionsConclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.

Application of Platelet-Rich Fibrin as Regeneration Assistant in Immediate Auototransplantation of Third Molar with Unformed Roots: Case Report and Review of Literature

Background Autogenous Tooth Transplantation (ATT) is the surgical movement of a maturely or immaturely formed tooth from its original site to another extraction site or a surgically prepared socket in the same individual. The most important factor in the healing process after autotransplantation is the presence of intact and viable periodontal ligament cells, which have the ability to differentiate into osteoblasts and able to induce bone production. ATT can successfully replace removable dentures as a restoration option in a growing patient, while implants can be placed only after skeletal maturity is attained. Case Presentation. In this case, we presented an immediate ATT of the third molar with unformed roots to the extraction socket of the first molar with evidence of continued root formation after 2 years of follow-up. Conclusion Platelet-Rich Fibrin (PRF) can induce sustainable and accelerated healing, and it can also induce the regeneration process of the periodontal tissues and pulpal formation. This process plays a key role in future root development and success rate.

Age Old Treatment with a Change: Auto Transplantation

One of the goals of dentistry is to replace missing teeth to restore function of mastication and aesthetics. Autogenous tooth transplantation or auto-transplant of natural teeth is the surgical transplantation of vital or root canal treated tooth from its original location in the mouth to another site of the same individual.The successful auto-transplantation of the third molar was initially reported by Fong in the year 1953. Auto-transplantation is a feasible, fast and economical option for the treatment of non-salvageable teeth. This is possible only when a suitable donor tooth is available. The outcome of any surgical procedure carried out is dependenton careful case selection along with detail understanding of biological principles involved in the procedure. Success rates reported in studies which are previously reported vary considerably, ranging from 74-100% for transplantation of third molars. The prognosis of auto-transplantation is generally good not only because of the probability of tooth integration inthe alveolar bone, but also due to lack of any his to compatibility problem which is associated with other kinds of transplant.

Evaluation of autogenous tooth transplantation for replacement of the missing or unrestorable mandibular molar tooth

This study was undertaken to evaluate the functional and occlusal stability of autogenous tooth transplantation. A total of 30 patients were included. Among them, 21 participants received transplanted first molar and the remaining 9 received transplanted second molar. In all the cases, donor tooth were third molar. In each participant, extraction of un-restorable first or second molar tooth was performed which was then replaced by atrumatic extracted third molar tooth. Each third molar tooth was placed in the recipient extracted socket, followed by the evaluation of the occlusion and then stabilized with arch bar and ligature wire. Clinical follow-up evaluation was performed at 15 days, 3 and 12 months in respect to occlusal stability, tooth mobility and periodontal status. It was found that 23 transplanted tooth were successful and the remaining 7 tooth need long-term observation for the final outcome, which was statistically significant. It can be concluded that the autogenous tooth transplantation can replace missing tooth to ensure the preservation of function, aesthetic and to prevent bone resorption of the missing area of the jaw, which can lead to exceptional esthetic and functional outcome.

Autogenous Transplantation for Replacing a Hopeless Tooth.

Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption.