Autotransplantation Of Teeth Research Articles

Autotransplantation of Tooth in Children with Mixed Dentition

Autotransplantation of tooth in children is the surgical movement of a tooth from one place in the mouth to another in the similar individual. Once thought to be uncertain, autotransplantation has achieved high success rates and is an outstanding option for tooth replacement in children. Although the indications for autotransplantation are narrow, careful patient assortment coupled with a suitable method can lead to exceptional esthetic and useful results. One benefit of this procedure is that placement of an implant-supported prosthesis or other form of prosthetic tooth replacement is not needed. A review of the recommended surgical technique as well as success rates is also discussed.

Tooth Autotransplantation with Autogenous Tooth- Bone Graft: A Case Report

The extracted right mandibular third molar of a 37-year-old man was transplanted into the first molar area, and a bone graft procedure using autogenous tooth-bone graft material was performed for the space between the root and the alveolar socket. Reattachment was achieved after 10 months. Therefore, autogenous tooth-bone graft material is considered reasonable for bone induction and healing in the autotransplantation of teeth.

Long-term observation of autotransplanted teeth with complete root formation in orthodontic patients

INTRODUCTION: Previous studies on tooth autotransplantation have mainly been reported from Scandinavia. They reported good long-term stability of autotransplanted teeth with incomplete root formati...

Retrospective long‐term evaluation of autotransplantation of premolars to the central incisor region

This retrospective case-series study aimed to examine the long-term outcomes of autogenously transplanted premolars. Twelve patients in whom donor premolars were used to replace maxillary central incisors lost by trauma were clinically and radiologically monitored. Standardized clinical and radiographic records were systematically obtained during the follow-up period of 14 years, to determine the influence of specific clinical criteria on the overall success rate of transplantation. The success rate of premolar autotransplantation in the maxillary central incisor area was 80% after 14 years follow-up. The highest success rate occurred in those teeth transplanted with two-thirds of full root development. Complete pulp obliteration was positively related to autotransplant viability, followed by root formation in the bony crypt. Autotransplantation of donor teeth, at the stage of ½ to ¾ of their expected root length, can provide a successful treatment solution for over 14 years.

A retrospective survey of autotransplantation of teeth in dental clinics

The aim of this study was to investigate the usage of tooth autotransplantation in dental clinics which offer the treatment and evaluate its practicality. Participating dentists were requested to provide information on transplantations they had undertaken from 1 January 1990 to 31 December 2010. A total of 614 teeth from 552 patients (37 dentists) ranging in age from 17 to 79 (mean age: 44·1) were examined. Cumulative survival rate and mean survival time were calculated using the Kaplan-Meier method, and log rank test was used for analysis of factors. The mean number of autotransplantation patients per clinic per year was 1·4. Upper third molars constituted 36·8% of donor teeth, while 37·1% were lower third molars. The lower first molar region was the most common recipient site at 32·6%, followed by the lower second molar region (28·0%). Prosthodontic treatment of transplanted teeth involved coverage with a single crown (72·5%) and abutment of bridge (18·9%). A total of 102 transplanted teeth were lost owing to complications such as attachment loss (54·9%) and root resorption (25·7%). The cumulative survival rate in cases where donor teeth had complete root formation was 90·1% at 5 years, 70·5% at 10 years and 55·6% at 15 years. The mean survival time was 165·6 months. Older age was a significant risk factor (P < 0·05) for survival. In cases where suitable donor teeth are available, autotransplantation of teeth may be a plausible treatment option for dealing with missing teeth in dental clinics.

Autotransplantation of ectopic teeth: a retrospective study of 284 teeth

AbstractObjective: To determine outcome in a series of autotransplanted teeth undertaken by the same surgeon over 25 years.Methods: This retrospective study examined the outcome of autotransplantation of 284 ectopic teeth – mainly maxillary canines – in a cohort group of 235 patients with a follow‐up of between 0.5 and 19 years (median 2.0). Indication for autotransplantation was severe tooth ectopia when orthodontic repositioning was considered unsuitable clinically or unacceptable to the patient. The technique involved minimal instrumentation and using a multibond appliance for stabilisation and fine tuning of tooth position. Outcomes were measured at the last clinic follow‐up.Results: Patients were aged between 9 and 51.8 years (median 15.4). Autotransplanted teeth comprised 254 maxillary canines, four mandibular canines, nine maxillary incisors, one mandibular incisor, five maxillary premolars and 11 mandibular premolars. Apices were fully formed in 202 teeth (71.0%). Only 11 transplants were known to fail, but including loss to follow‐up, there was a 96% 5‐year survival and 65% 10‐year survival. Of the survival group, 180 (66.9%) were vital with no root resorption, 57 (21.2%) were non‐vital with normal radiographic appearances and 32 (11.9%) were root filled with normal radiographic appearances. There was no significant difference in survival between open and closed apices (P = 0.90). Of the failed group, four (36.4%) had root resorption requiring extraction and seven (63.6%) were lost.Conclusion: The findings are consistent with other studies in the field. Tooth transplantation should be considered when planning rehabilitation for patients presenting with ectopic teeth.

Autotransplantation of a maxillary first premolar to replace an ankylosed maxillary incisor: 7-year follow-up

To present the combined endodontic, surgical and orthodontic treatment of an autotransplanted maxillary first premolar for the replacement of an ankylosed maxillary incisor. This case report describes the autotransplantation of a maxillary premolar after the extraction of an ankylosed incisor in a 13-year-old boy. To allow better adaptation of the donor tooth, the buccal root of the first premolar was removed using a diamond bur and the denuded root site was filled with acid-etched composite resin. The palatal root canal was dressed with calcium hydroxide for 2 months before filling with gutta-percha. Autotransplantation of a remodelled maxillary first premolar was achieved to substitute for the ankylosed maxillary central incisor. Orthodontic treatment was performed to correct an Angle Class II malocclusion. Seven years after root canal treatment, the autotransplanted tooth and supporting tissues appeared healthy both clinically and radiographically and were functioning well. • Autotransplantation is a viable option for the treatment of a missing tooth or for the replacement of a traumatized tooth when there is a donor tooth available. • Autotransplantation of a premolar for replacement of a missing anterior tooth is sometimes a suitable alternative to conventional prosthetic rehabilitation or implant treatment in young individuals. • Proper combined endodontic and orthodontic treatment of autotransplanted teeth might be possible without periodontal complications.

Clinical study on root resorption of autotransplanted teeth with complete root formation

Introduction The main reasons for the unsuccessful autotransplantation of teeth are the failure of initial healing and root resorption. The aim of this study was to elucidate the relationship between donor teeth factors and the prognosis of the transplants in which root resorption occurred. Materials and methods The study evaluated 110 patients with 117 transplants. The successful group included the cases which healed well, with only minor problems. The unsuccessful group included the cases with transplant-loss and progressive problems. The unsuccessful group and minor-trouble cases were judged with the type of problems; i.e. failure of initial healing, root resorption, and others. Root resorption was classified into 3 types; inflammation resorption, replacement resorption and cervical root resorption. The prognostic factors were evaluated to analyze the difference between rapidly progressing root resorption and the stable resorption. Results There were 20 unsuccessful transplants. In the unsuccessful group, rapidly progressing replacement root resorption was observed in 11 transplants. In the successful group, minor problems such as stable root resorption were found in 16 transplants. At least one of the atypical root shapes (divergent, curve, and hypertrophy), probing pocket depth of more than 4 mm, and/or extrusion were significantly more frequent in the replacement root resorption cases compared to cases with no significant findings. Probing pocket depth of more than 4 mm and/or extrusion, dental caries, history of restoration, root canal treatment were significantly more frequent in rapidly progressing replacement root resorption cases compared to stable root resorption cases. Conclusions Abnormal root shape, deep periodontal pocket, dental caries, restoration and root canal treatment of donor teeth are factors associated with progressive replacement root resorption after the autotransplantation of teeth.

Stabilization of autotransplanted teeth using thermoplastic retainers

Different fixation techniques have been used for stabilization of autotransplanted teeth. Because rigid or extended fixation periods can cause complications such as ankylosis and disturbances of pulpal revascularization, our aim was to evaluate an alternative technique, a removable splint, for improving the success rate of autotransplanted molar teeth. In 44 patients, (20 male and 24 female patients), 45 transplanted teeth were analyzed. These cases were followed for 31 to 47 months after operation. Transplanted teeth were evaluated after use of a thermoplastic retainer for 1 month, in terms of success rate and dissatisfaction with this apparatus. The primary stability, ankylosis, and root resorption were also analyzed. To date, 1 transplant was extracted after 6 months due to unpreventable periapical root inflammation, and 2 transplants were extracted after one year due to external root resorption. Although 2 ankylosed transplants were still functional after an average follow-up period of three years, with no dissatisfaction by the patients, these cases were treated as failures because of the probable risk for external root resorption. The remaining 40 (88.8 % success rate) transplants remained asymptomatic and functioning for a mean follow-up period of 37 months. In the assessment of dissatisfaction with the thermoplastic retainer, 36 (81.8 %) patients had no or little dissatisfaction, 4 (9 %) patients had very appreciable or excessive dissatisfaction, and 4 (9 %) patients had moderate dissatisfaction. A thermoplastic retainer for use after autotransplantation of third molar teeth is a reasonable and useful method and a good alternative to conventional rigid or semi-rigid splints. This technique was especially useful in autotransplanted teeth that had poor stability, i.e., in cases in which it is conventionally advised to use long-term rigid or semi-rigid splints.

Autogenous tooth transplantation: Evaluation of pulp tissue regeneration

The aim of this study was to assess the pulp survival that occur in transplants of autologous teeth, by comparing two surgical techniques: the conventional technique (autotransplantation for newly formed alveoli), and an alternative technique, (autotransplants for alveoli in the initial phase of healing). In each surgical techniques were applied, randomly, either saline solution or Emdogain®. The study group comprised 26 patents, in which 28 teeth were transplanted to recipient sockets prepared mechanically. Of the 28 teeth transplanted, 4 were intentional replants, and of the remainer, 11 had the apex closed and 13 open. The mean age at the time of transplantation was 22.34 ± 8.14 years (mean ± SD). The transplantation were performed by the same operator, with the informed consent of the patient and authorized by the ethical committee of the hospital. Clinical and radiological examinations were performed during 24 to 65 months (48 ± 12.96; MED ± SD), from 10 days, 1 month, 3 months, 6 months and annually to 5.6 years. Only two transplanted teeth were lost, due persistent apical periodontitis, and one transplanted patient with open apex missed the treatment. In the teeth with pulp, we needed to perform root canal therapy in 9. In the 73% of the teeth with closed apex, we needed to perform root canal treatment, with no statistically significant difference found among closed apex and root canal therapy (p=0.083). In only 8% of the teeth with open apex did we need to perform root canal treatment, with an association between open apex and root canal therapy (p=0.0002). The overall success rate was 98% with significant difference for losses (p=0.0001). Although not a frequent procedure, it was concluded that autotransplanted teeth, performed with appropriate surgical care had a good prognosis, and can render a very useful service to the patients.

Dental auto-transplantation to anterior maxillary sites

To investigate the indications for, and the outcome of auto-transplantation of teeth to the anterior maxillary region. From 1978 to 1994, 41 teeth in 31 subjects were transplanted to anterior maxillary sites at the Department of Oral Surgery, Stavanger University Hospital, Norway. All transplantations were performed by one oral surgeon (B.G.). Relevant information was collected from patients' files, including radiographs of the tooth graft, the recipient site and follow-up radiographs. The mean observation period was 55.1 months (range 1-158 months). The age of the patients at the time of the auto-transplantation ranged from 10 to 30 years (mean 14.8 year). The most common indications for auto-transplantation were aplasia (41.5%), sequelae of trauma (36.6%) and impacted or ectopic teeth (17.1%). Eight teeth were judged to be failures; five had been extracted because of severe root resorptions and periodontal infection and three were judged as failures owing to severe ongoing root resorption but remained in the alveolus. Trauma is as common indication as aplasia for transplantation. From a biological point of view, dental auto-transplantation to the anterior maxillary region has a high success rate. Hence, auto-transplantation is an important treatment option for missing or lost maxillary anterior teeth where preservation of the alveolar bone is important during growth and development in adolescents. The major reason for failure was various types of root resorptions, some of which were detected late.

Tooth Autotransplantation as a Treatment Option: A Review

Autotransplantation can provide patients with all the benefits of a natural tooth, but is seldom considered as a treatment option, in large part because of a lack of knowledge about periodontal tissue or the anatomy of teeth. The authors conducted a literature search using the PubMed database. They searched for key words including "autotransplantation," "clinical indications," "sequence and treatment procedures," "healing factors and prognosis" and "treatment options". Autotransplantation demonstrates as a viable treatment alternative, especially in growing adolescents. It provides a biological and economical treatment option for tooth replacement.

Long-term observation of autotransplanted teeth with complete root formation in orthodontic patients

The objective of this investigation was to examine the factors influencing the long-term prognosis of autotransplanted teeth with complete root formation. Thirty-eight teeth, autotransplanted in 32 patients, were examined more than 6 years after transplantation. Periodontal health, condition of restoration, mobility, occlusal contact, level of gingival margin, and course of orthodontic movement were investigated clinically and with radiographs. More than 6 years after autotransplanation, 33 teeth survived in 27 patients. The survival rate was 86.8% (mean observation time, 9.2 years). Abnormal findings were observed in 9 teeth, so the success rate was 63.1%. An inadequate root filling tended to give rise to abnormal findings. The success of autotransplantation of a tooth with complete root formation is affected by the quality of root filling. When possible, clinicians should consider autotransplantation before root formation is complete.

Clinical study on immediate autotransplantation of teeth with complete root formation

Clinical study on immediate autotransplantation of teeth with complete root formation

Proliferation of epithelial rests of Malassez following auto-transplantation of third molars: a case report

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.

Does removal of the original pulp tissue before autotransplantation influence ingrowth of new tissue in the pulp chamber?

In an attempt to extend the indication area for autotransplantation of vital teeth, two possibilities can be proposed: (i) The enlargement of the apical foramen, with the aim to facilitate revascularization and ingrowth of new tissue. The ingrowth of tissue will eliminate the need for endodontic treatment when mature teeth are transplanted and (ii) the cryopreservation of teeth in case they cannot be transplanted immediately to the receptor site. Teeth with an ideal stage of root formation can be cryopreserved to perform transplantation later. Although pulpcell cultures survive crypreservation in vitro, the pulp tissue cannot survive the cryopreservation procedures when it is kept inside the pulpchamber. Therefore, the pulp tissue has to be removed before cryopreservation. It has been demonstrated that revascularization and ingrowth of new tissue can occur in an empty pulp chamber (1). The aim of this study was to find out if revascularization and ingrowth of new pulp tissue is influenced by removal of the original pulp tissue before autotransplantation. Twenty nine single-rooted teeth from three adult beagle dogs were transplanted after resection of the root tip. One group of teeth (n = 14) had the pulp tissue removed before transplantation. The other group (n = 15) had the original pulp left in situ. The transplanted teeth were histologically analysed 90 days post-transplantation. In the group with the tissue left in situ, 12 teeth (80%) showed a pulp chamber totally filled or at least 1/3 to 2/3 filled with viable tissue. In the group with the pulp tissue removed, 11 teeth (79%) had no or little vital tissue in the pulp chamber. The necrotic masses that develop in the original pulp tissue immediately after transplantation are a possible stimulating factor in the repair process of the pulp. As a conclusion, it can be stated that in case of autotransplantation of teeth, it is advisable to leave the pulp tissue in situ to stimulate the revascularization and ingrowth of new tissue after transplantation.

Survival and success of maxillary canine autotransplantation: a retrospective investigation

The aim of this study was to evaluate survival and success rates following autotransplantation of permanent maxillary canine teeth. Sixty-three cases of maxillary canine autotransplantation from 49 subjects (mean age at transplantation 21.8 years, range 13-42.1 years) undertaken between 1977 and 2003 were collected as part of an audit project of transplantation success. All maxillary canines had complete root development at the time of transplantation. The sample was divided into two groups, a matched case-control study to compare 27 unilateral transplanted canines with the non-transplanted canine on the contralateral side, and all 63 transplanted canines with no controls. Teeth were assessed clinically using established criteria for success: tooth presence for survival and resorption, mobility, probing pocket depth (PPD), gingival bleeding, vitality, and colour. Radiographic investigation for success assessed internal and external inflammatory resorption (including the amount) bone levels and any signs of pathology. Data were described with descriptive statistics and analytical tests were used to assess frequencies of occurrence. The survival rate was 83 per cent with an average duration of 14.5 years in situ. Thirty-eight per cent of the transplants were deemed successful. There were statistically significant associations between the transplanted and non-transplanted teeth in PPD (P = 0.006), gingival bleeding (P = 0.006), vitality (P = 0.004), and colour (P = 0.002). Autotransplantation of impacted maxillary canines can be successful in the long term and may be indicated in selected cases. Although the rate for complete success in this study was low (no signs of resorption, mobility, and sound periodontal tissues), the survival rate can be considered favourable when evaluating autotransplantation as a treatment option for grossly malpositioned canines with little scope for orthodontic alignment.

Quantitative scintigraphic analysis of pulp revascularization in autotransplanted teeth in dogs

Objective: The purpose of this study was to evaluate the pulpal changes associated with autogenous single-rooted immature tooth transplantation in dogs, using either one, or two-stage surgical techniques. Methods: Teeth from 3 beagle dogs, 5 months old, were extracted and transplanted to mechanically prepared recipient sockets. Group (A), where the teeth were transplanted using a one-stage method to recipient beds prepared immediately before transplantation. Group (B), where the teeth were transplanted using a two-stage method in which the recipient beds were prepared and left to heal for 7 days before transplantation. Clinical examinations were done every week during 9 weeks. After 9 weeks, the animals were injected with 99mTechnetium hydroxylmethylene diphosphonate ( 99mTc-HMDP) and 3 h after injection, a whole body scintigraphic acquisition was performed. After scintigraphic acquisition the animals were euthanized and the teeth extracted and its radioactivity counted in a well counter calibrated to 99mTc. With the data obtained, the percentage of activity injected was calculated for each tooth. The data for each group of teeth were evaluated and analyzed using the Mann–Whitney test ( p = 0.05). Results: All the transplanted teeth in both groups survived. No statistically significant difference was found in the absorption of the 99mTc-HMDP, between the treatment groups ( p = 0.464) and between them and the control group (Group A vs. control p = 0.713 and Group B vs. control p = 0.157). Conclusions: This study demonstrated that there was no difference between the two surgical techniques in terms of the pulp revascularization in transplanted teeth.

Clinical study on prognostic factors for autotransplantation of teeth with complete root formation

Autotransplantation is often performed to replace a missing tooth, but tooth autotransplantation has been reported in fewer teeth with complete root formation than those with incomplete root formation. The aim of this prospective study was to evaluate the factors that affect the prognosis of autotransplantation of teeth with complete root formation. 109 patients with 117 transplants were studied. Of the 117 transplants investigated, 14 (12%) failed during the observation period. The overall 1-year survival rate was 96%; the 5-year survival rate was 84%. The major causes of failure were unsuccessful initial healing and replacement root resorption with periodontal inflammation. Factors significantly associated with unsuccessful transplantation, in single factor analysis, were age 40 years or more, molar tooth as donor, probing pocket depth to 4mm or more, history of root canal treatment, multi-rooted teeth and fixation with sutures. Pocket depth of 4mm or more and history of root canal treatment appeared to increase the risk of unsuccessful transplantation in multivariate analysis. It is suggested that the pocket depth of the donor tooth and history of root canal treatment are related to the healing of paratransplantal tissue and root resorption.

Accuracy and surgical feasibility of a CBCT‐based stereolithographic surgical guide aiding autotransplantation of teeth: in vitro validation

The aims of this study were to determine the accuracy of a 3D computer model and stereolithographic (STL) replica when compared to the real tooth and to develop a cone beam computed tomography (CBCT)-based planning technique including surgical guide fabrication. A STL surgical guide and a tooth replica were fabricated using SimPlant Pro 12.1. To validate this process, tooth segmentation and replica design were prepared for comparison to an optical scan of the corresponding tooth. For surgical intervention, a dry dentate mandible was scanned using a Scanora CBCT and the donor tooth was segmented. The donor tooth was repositioned, and two guides were designed. These tooth replica and guides were used in socket preparation of the dry mandible. The 3D computer model of the segmented teeth and related STL models showed satisfactory results with an acceptable accuracy. The surfaces were within 0·25mm distance, but in some areas up to 2·5mm deviation were seen. The results showed that 79% of the points was between 0·25 and -0·25mm, 3% was overestimated (>0·25mm) and 18% was underestimated (<-0·25mm). The computer-based repositioning of the donor tooth and construction of tooth replica and guide allowed socket preparation before donor tooth extraction and optimization of the STL procedure for in vivo planning of CBCT-based autotransplantation.