Autotransplantation Of Teeth Research Articles

Success predictive factors of teeth subjected to autotransplant: An umbrella review

Abstract Introduction: A dental autotransplant is a controlled case of dental avulsion based on the transplantation of erupted teeth within the same individual, from one place to another, in sites where an extraction was performed or that were surgically prepared. Autotransplantation has become a viable method to replace lost teeth since transplanted teeth may operate as fully normal teeth. Objective: The objective of this study was to summarize the available scientific evidence regarding predictors of success in autotransplanted teeth. Materials and Methods: A systematic review of systematic reviews, known as an umbrella review, was performed. Two calibrated and standardized investigators independently analyzed the quality using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and evaluated the confidence level and bias review with the Amstar-2 guideline. The PubMed, Embase, and Scopus databases were used. The search was conducted in August 2022 and updated on March 22, 2023. Systematic reviews or meta-analyses carried out from publications on human beings, between 2017 and 2022, were included. Results: From 104 achieved, 4 systematic reviews and meta-analyses were assessed. The overall survival of autotransplanted teeth ranged from 81% to 98%, the prevalence of overall inflammatory root resorption ranged from 2.1% to 43%, and the prevalence of ankylosis ranged from 1.2% to 43%. Predictive factors for success identified in the literature included tooth type or root development and clinical intervention factors, including socket preparation, splinting, occlusion control, antibiotic regimen, treatment time of endodontics, and orthodontic treatment. Conclusions: The existing evidence on autotransplanted teeth in humans indicates that the survival rate of such teeth involves a series of presurgical and surgical variables. Analyses of factors associated with complications or failures still require primary studies where associations may be made to draw more solid conclusions.

Influence of augmented reality technique on the accuracy of autotransplanted teeth in surgically created sockets

BackgroundThe objective of the present study was to evaluate the reliability of an augmented reality drilling approach and a freehand drilling technique for the autotransplantation of single-rooted teeth. Materials and methodsForty samples were assigned to the following surgical techniques for drilling guidance of the artificial sockets: A. augmented reality technique (AR) (n = 20) and B. conventional free-hand technique (FT) (n = 20). Then, two models with 10 teeth each were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan. Afterwards, the autotrasplanted teeth were planned in a 3D dental implant planning software and transferred to the augmented reality device. Then, a postoperative CBCT scan was performed. Data sets from postoperative CBCT scans were aligned to the planning in the 3D implant planning software to analize the coronal, apical and angular deviations. Student’s t-test and Mann–Whitney non-parametric statistical analysis were used to analyze the results.ResultsNo statistically significant differences were shown at coronal (p = 0.123) and angular (p = 0.340) level; however, apical deviations between AR and FT study groups (p = 0.008) were statistically significant different.ConclusionThe augmented reality appliance provides higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique.

Autotransplanted premolars for substituting traumatic maxillary central incisors in a Class II growing patient

A 10-year-old young Hispanic male patient was referred to the Endodontics Department with the chief complaint of color change of maxillary central incisors. The parents reported trauma one year before and as a result root canal treatment; maxillary central incisors extractions were necessary due to poor prognosis, so he was referred to the Orthodontics Department to evaluate if the patient could be the candidate for orthodontic treatment, as he showed severe crowding. The patient had no medical conditions, and the pretreatment records showed a Class II skeletal relation and vertical pattern. Dental findings were mixed dentition, an Angle Class II molar relationship, moderate upper and lower anterior crowding, 4 mm of overbite, and 7 mm of overjet. The patient underwent autotransplantation of maxillary second premolars into the place of maxillary central incisors that needed to be extracted as stated by the endodontist (premolar extractions were needed to solve the orthodontic problems). The suggested position for the autotransplant teeth was not accomplished by the surgeon, so orthodontic forces were applied to the autotransplant teeth to the ideal position. At the end of orthodontic treatment, the autotransplanted teeth were restored by the prosthodontist. Therefore, the facial balance improved, and the final occlusal relationships were good. COVID-19 global lockdown was a challenging obstacle to overcome during treatment. This case report intends to highlight the potential benefits of tooth autotransplantation and to increase awareness of this treatment protocol.

AUTOTRANSPLANTATION OF TEETH WITH OPEN APICES MAY RESULT IN HIGH SURVIVAL RATES BUT EVIDENCE IS LIMITED

Tooth autotransplantation: an umbrella review. Tan BL, Tong HJ, Narashimhan S, Banihani A, Nazzal H, Duggal MS. Dent Traumatol 2023;39(Suppl 1):2-29. Open access funding provided by the Qatar National Library TYPE OF STUDY/DESIGN: Umbrella review.

Developing Advanced Patient-Specific In Silico Models: A New Era in Biomechanical Analysis of Tooth Autotransplantation

IntroductionAs personalized medicine advances, there is an escalating need for sophisticated tools to understand complex biomechanical phenomena in clinical research. Recognizing a significant gap, this study pioneers the development of patient-specific in silico models for tooth autotransplantation (TAT), setting a new standard for predictive accuracy and reliability in evaluating TAT outcomes. MethodsDevelopment of the models relied on 6 consecutive cases of young patients (mean age 11.66 years ± 0.79), all undergoing TAT procedures. The development process involved creating detailed in silico replicas of patient oral structures, focusing on transplanting upper premolars to central incisors. These models underpinned finite element analysis simulations, testing various masticatory and traumatic scenarios. ResultsThe models highlighted critical biomechanical insights. The finite element models indicated homogeneous stress distribution in control teeth, contrasted by shape-dependent stress patterns in transplanted teeth. The surface deviation in the postoperative year for the transplanted elements showed a mean deviation of 0.33 mm (±0.28), significantly higher than their contralateral counterparts at 0.05 mm (±0.04). ConclusionsBy developing advanced patient-specific in silico models, we are ushering in a transformative era in TAT research and practice. These models are not just analytical tools; they are predictive instruments capturing patient uniqueness, including anatomical, masticatory, and tissue variables, essential for understanding biomechanical responses in TAT. This foundational work paves the way for future studies, where applying these models to larger cohorts will further validate their predictive capabilities and influence on TAT success parameters.

Retrospective Follow-up Assessment of Risk Variables Influencing the Outcome of Autologous Tooth Transplantation

IntroductionThis retrospective study aimed to identify which patient-, donor tooth–, recipient site–, and surgical procedure–related variables may influence the outcome of tooth autotransplantation. MethodsThe sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models. ResultsAfter a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05). ConclusionBased on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient’s bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.

Evaluation of Bone Growth around Autotransplanted Teeth Using Cone-Beam Computed Tomographic Images

IntroductionThe aim of this observational study was to evaluate bone growth at the recipient site of autotransplanted teeth using cone-beam computed tomography (CBCT) images and to compare it to the control tooth. MethodsBone growth was measured on CBCT images obtained from the anterior region of the maxilla, which received a single transplant of immature premolars due to early loss of the central incisor. The results were compared to the bone growth of contralateral central incisor that served as control. The sample consisted of 13 autotransplanted teeth and 13 control teeth. It was determined the thickness of the buccal bone of the marginal ridge, the thickness of the palatal bone of the marginal ridge, the height of the maxillary bone, and the thickness of the maxillary bone at its mid-height. The measurements were analyzed statistically, adopting a significance level of 5%. ResultsThe mean interval between the dental autotransplantation surgery and the CBCT scan was 16.2 years. The mean thickness of the buccal bone of the marginal ridge, thickness of the palatal bone of the marginal ridge, height of the maxillary bone, and thickness of the maxillary bone at its mid-height were, respectively, 0.85, 0.94, 19.6, and 8.85 mm for autotransplanted teeth and 0.79, 1.09, 18.88, and 8.5 mm for control teeth. There were no significant differences in the bone measurements between autotransplanted and control teeth (P > .05). ConclusionsThe growth of maxillary bone in the region that received the autotransplanted tooth was proportional to that of maxillary bone that supports the contralateral tooth. Thus, autogenous transplantation is efficient in maintaining the bone architecture at the recipient site.

Evaluation of the 3D Technology in the Auto-transplantation: An Original Research

ABSTRACT Introduction: Using three-dimensional printed duplicates of the donor teeth, three-dimensional auto-transplantation is a medical procedure that moves a tooth from one location inside a patient to another. The intraoperative practicability during 3D auto-transplantation of teeth was evaluated in the present study. Material and Methods: A prospective multicenter clinical study was done among the subjects. “Preoperative cone-beam computed tomography imaging,” “computer-assisted design (CAD),” and “computer-assisted manufacturing (CAM)” were used in all operations to make a 3D duplicate of the donor teeth. The clinical parameters that were evaluated were the time required for the fit, number of attempts to fit, and intra-operative experience. Results: Canines, premolars, molars, and one extra tooth were all transplanted during the 200 auto-transplantation surgeries among 152 subjects. An initial satisfactory fit of the donor tooth and an extra-alveolar time of less than one minute were achieved in 80% of the surgeries. The extra-alveolar time exceeded 3 minutes in ten teeth. Difficulties that were faced were related to the imaging, patient cooperation, and the bone quality. Conclusions: The application of the duplicate teeth by 3D printing of a donor tooth all through auto-transplantation techniques reduced the time the tooth stays extra-alveolar as well as the efforts at transplant fitting during implantation. This allowed for more challenging surgeries as well as a speedy and reliable therapy.

Bilateral Digitally Aided Tooth Autotransplantation: A 2-Year Case Report.

Tooth autotransplantation is an effective treatment to replace missing teeth. Digital planning can facilitate successful autotransplantation. Guiding templates are highly recommended when performing cases in healed ridges in the posterior area to reduce excessive bone loss and increase the chances of fitting the donor tooth in the new socket. This case report highlights the use of 3D planning tools and fully guided drilling templates for successful tooth autotransplantation in the posterior area. Two tooth autotransplantations were performed in a 51-year-old patient using mandibular third molars to replace hopeless mandibular first and second molars. Root canal treatments were carried out before the surgeries, and different alveoloplasty techniques were used in each recipient area. The prosthetic phase was carried out after 9 months. Both teeth were asymptomatic, functional, and exhibited no signs of resorption or apical radiolucency and showed complete regeneration of the periodontal apparatus at the 2-year follow-up.

Regenerative endodontic therapy after autogenous transplantation of mandibular third molar

Autogenous tooth transplantation involves moving a tooth from its original position to replace a missing tooth. Complications, such as pulp necrosis, can occur following autotransplantation of teeth with incomplete root formation. There are insufficient studies on managing pulp necrosis in autotransplanted immature teeth by regenerative endodontic treatment (RET). In this case, a 21-year-old woman developed a sinus tract 3 months after autotransplantation of an immature third molar that replaced the lower left mandibular first molar. She presented with pain while chewing in the area of her autografted third molar. Based on clinical findings and periapical radiolucency in radiographic findings, the tooth was diagnosed with necrotic pulp and apical periodontitis. It was decided to perform RET for the tooth. The tooth underwent chemomechanical debridement and calcium hydroxide dressing in the first session. After 2 weeks, the patient’s pain and sinus tract were resolved. In the second session, the periapical tissue was stimulated by inserting a K-file 2 mm over the apex to induce bleeding in the root canal. Mineral trioxide aggregate was placed over the blood clot, and the tooth received final restoration. After 11 months of recall appointments, the apical foramen size had decreased the thickness of the apical dentin wall increased, there was no periapical pathosis, and the periodontal ligament space width was normal. This case report provides valuable insights into the pulpal management of autotransplanted immature teeth.

Teeth autotransplantation as an alternative to dental implantation

The stages of preoperative planning and surgical treatment of compromised teeth by the method of autotransplantation of a tooth are presented on the example of two clinical cases. The autotransplantation method can be considered an alternative to dental implantation when strictly adhering to the surgical protocol and careful selection of patients.

Assessment of an original dental autotransplantation technique: A retrospective study and proposal of a method.

Successful tooth autotransplantation (TAT) requires preservation of the periodontal ligament (PDL) on donor teeth and good vascularization of the recipient site to ensure maintenance of alveolar bone volume through physiological stimulation of PDL. This retrospective study aims to evaluate the survival and success rate of a two-step procedure that uses dual periodontal stimulation and a 3D replica of the transplanted tooth to promote ligament repair and prevent ankylosis and root resorption. All consecutive patients followed at the dental center of Rennes and having undergone a TAT in two surgical stages with double periodontal stimulation and the use of a 3D replica of the transplanted tooth between 2017 and 2022 were invited for follow-up clinical and radiographic examination. First, survival rates were calculated on the basis of a telephone survey. Then, a clinical and radiological follow-up examination was used to calculate the success rate. Of these 22 transplants, 21 were still functioning, and 1 had been extracted, giving a 95,5% probability of survival after a median follow-up of 23 month. Of the 21 teeth eligible for success analysis, clinical and radiological follow-up showed a success rate of 90,5% with normal PDL and no ankylosis. The teeth auto-transplanted by this procedure gave a very satisfactory survival and success rate in the medium term. This study suggests that this standardized autotransplantation procedure potentiates PDL healing and may be a viable and predictable treatment in current clinical practice, especially when orthodontic treatment is required. Key words:Tooth autotransplantation, 3D printing, periodontal regeneration, bone regeneration.

Dental Auto Transplantation: A Promising Treatment for Public Health System

Introduction: Tooth autotransplantation is a biological and innovative technique for the rehabilitation of compromised or missing teeth. It involves the surgical repositioning of healthy teeth in the dental arch to restore the functions of the stomatognathic system. Despite being a promising technique, few professionals have performed dental autotransplantation in clinical practice. Aim: To review the literature and evaluate the clinical success rate and factors associated with the technique of dental autotransplantation, focusing on its application especially in the Brazilian public health system. Methods: Articles were searched in PubMed (Medline), Scielo and Google Scholar databases for a period of 10 years (2012- 2022) by two independent authors. Clinical studies and case series about dental autotransplantation presenting more than 10 patients older than eight years, and a follow-up longer than one year were included. Results: A total of 320 articles were eligible for inclusion, of which 57 were selected for full-text evaluation. Fifteen articles were included in this review. A total of 1048 patients were reported in the articles, with an age range of 8 to 58 years and a followup of 1 to 29 years. The mean success rate was 86.79%. Molars were the most commonly used teeth for autotransplantation. Conclusion: Dental autotransplantation has high success rates and proves to be an excellent, low-cost therapeutic option that should be promoted in clinical practice, especially in the public service.

自体牙移植中人工牙槽窝预备的新趋势

自体牙移植中人工牙槽窝预备的新趋势

Effectiveness evaluation of autotransplanted teeth after performing extraoral endodontic surgery instead of conventional root canal therapy

PurposeThe aim of this study was to examine the viability and efficacy of utilizing extraoral apicoectomy and retrograde filling in combination to seal the root canal system of mature molars without the need for root canal therapy (RCT) during the autotransplantation of teeth (ATT).Materials and methodsThis study screened 27 patients who received ATT at the Department of Oral Surgery in the Hospital of Stomatology from 2019 to 2021. Extraoral apicoectomy and retrograde filling were performed, while RCT was temporarily not performed. The study analysed the periodontal status and masticatory function of transplanted teeth one to three years postoperation and used cone-beam computed tomography (CBCT) and periapical radiograph (PA) to evaluate the integrity of the periodontal space and intra/periapical inflammation. The potential predictors of survival/success were analysed statistically. We also conducted questionnaires and chewing efficiency tests.ResultsIn this study, 27 TTs from 27 patients were found to be fully functional in terms of chewing ability. The overall survival rate was 100% (27/27), and the success rate was 70.4% (19/27). A total of 90.9% (20/22) of patients reported being satisfied or very satisfied with their TTs. Additionally, the chewing efficiency of the transplantation side was on average 82.0% of that of the healthy side, with a significant difference between the two sides (P < 0.05). None of the potential predictors were found to significantly affect the success or survival of the transplanted tooth (TT).ConclusionThe combination of extraoral apicoectomy and retrograde filling in TT showed promising outcomes, but further clinical cases and longer follow-up times are still required to validate the treatment plan.

Validation of a Cox prognostic model for tooth autotransplantation.

This study aimed to validate our Cox proportional hazards prognostic model for autotransplantation of teeth with complete root formation using prognostic index (PI) and determine whether the prognosis can be predicted. The Protocol group, as a training data set for validation, consisted of 259 autotransplanted teeth to create a PI using the Cox model, as described previously. The Pre-protocol group, as the first validation data set, consisted of 95 autotransplanted teeth treated without a protocol. The Post-protocol group, as the second validation data set, consisted of 61 autotransplanted teeth obtained after the establishment of the prognostic model. Because four prognostic factors, including history of root canal treatment (yes), number of roots (multirooted), source of donor tooth (maxillary tooth), and duration of edentulism (≥2.5 months), were selected as a Cox prognostic model, 16 patterns of PI were constructed. First, the autotransplantated teeth in the Protocol group were divided into low- and high-risk groups respectively according to the median of PI as the cutoff value. The survival curves of low- and high-risk groups were calculated using the Kaplan-Meier method and tested using the log-rank test. Then, in the Pre- and Post-protocol groups, all transplanted teeth were divided into low-and high-risk teeth by the median of PI and the survival curves of low- and high- risk teeth were analyzed statistically in a similar manner. The survival curves of the low- and high-risk groups diverged significantly in the Protocol and Post-protocol groups. In the Pre-protocol group, the curves of the low- and high-risk groups were separated, and the low-risk survival rate was improved. Our Cox prognostic model for autotransplantation of teeth with complete root formation was useful in predicting the prognosis by external validation using PI.

Three-dimensional analysis of the alveolar ridge profiles of maxillary central incisors in children for autotransplantation

BackgroundSufficient alveolar housing is fundamental to ensure the favorable prognosis of autotransplanted teeth. However, little is known about the alveolar ridge profiles of the anterior maxilla in children. Therefore, this study aimed to investigate the alveolar ridge profiles of the anterior maxilla in growing children. MethodsA total of 169 Korean children aged 10–13 years old were included in this retrospective study. Demographic data and cone-beam computed tomography scans of 244 maxillary central incisors were collected. For each tooth, the alveolar ridge thickness was determined at 1-, 3-, and 5-mm levels below the cemento-enamel junction. The alveolar process height and labial concavity were also evaluated. Statistical analyses were performed to evaluate differences according to age and sex. ResultsThe alveolar ridge thickness did not differ according to age. The alveolar ridge thickness in males was significantly greater than that in females among those aged 10 and 11 years. The average alveolar process height was 17.43 ± 2.22 mm. The alveolar process height hardly changed with age from 10–13 years, whereas the alveolar process height of males was significantly greater compared with that of females among those aged 10 years. The labial concavity was approximately 150˚, with no significant differences between age and sex. ConclusionsWithin the limits of this study, the anatomy of the alveolar ridge in the maxillary central incisors showed sufficient capacity as a recipient site for autotransplantation using mandibular premolars, especially in males. These findings serve as a valuable resource for facilitating autotransplantation in children.

Computer-aided design and computer-aided manufacturing poly (methyl methacrylate) interim veneers for immediate esthetic restoration of autotransplanted teeth.

Autotransplanted teeth in the maxillary anterior region should be restored or reshaped as soon as possible for functional and esthetic reasons as well as the well-being of the patient. However, such tooth restorations are frequently not carried out immediately after tooth transplantation because the process could have a negative impact on the healing process. The development of a simple, immediate, and atraumatic esthetic interim restoration would be of great benefit to both the clinician and patient and address all the concerns caused by immediately preparing the tooth postoperatively and cementing a permanent restoration. This report describes the use of CAD-CAM technology to create poly (methyl methacrylate) veneers preoperatively that can be cemented extraorally on the extracted donor tooth for the immediate and interim recontouring of autotransplanted anterior teeth.

Autotransplantation for Restoration of Dentition Defects After Excision of Jaw Cysts.

Bone defect caused by jaw cystectomy has always been the main factor affecting postoperative wound healing and is also the common cause of maxillofacial bone defect, which brings challenges to the subsequent restoration of missing teeth. In this paper, the authors report a 22-year-old young woman who had a mandibular cyst in the left lower posterior tooth area. She underwent mandibular bone cyst excision and simultaneous extraction of teeth 36 and 37. One and two months after the removal of the mandibular bone cyst, autologous tooth transplantation was performed in stages from tooth 28 to tooth 36 and from tooth 18 to tooth 37. The case shows that tooth autotransplantation is a viable option for the restoration of dentition defects after the excision of jaw cysts, which can promote the healing of the bone defect after the operation.

Auto-Transplantation of Teeth: A Descriptive Cross-Sectional Study of Knowledge and Attitude

Auto-Transplantation of Teeth: A Descriptive Cross-Sectional Study of Knowledge and Attitude