Root development of immature third molars transplanted to surgically created sockets.
ABSTRACT The aim of this study was to compare root development after transplantation of teeth into surgically created sockets or into fresh extraction sites.
The sample consisted of 62 patients with a total of 64 transplanted immature third molars. All transplants were at root development stages 3 to 4. In 22 cases, a new socket was created by means of burs. Forty-two teeth transplanted into a fresh extraction site served as controls. Postoperative root development was determined on intraoral radiographs taken immediately after transplantation and at the final follow-up. For all transplants, extraoral storage time and number of trials were recorded during transplantation.
No significant intergroup differences were observed at root development stage 3. In contrast, at root development stage 4 transplantations to surgically created sockets showed a significantly lower final root length (P = .025) and root length increment (P = .038) than transplants in the control group. In addition, a significant correlation was determined in the prepared socket group at developmental stage 4 between root length increment and extraoral storage time (r = -0.910, r(2) = 0.828, P < .001) or number of trials in the recipient socket (r = -0.775, r(2) = 0.601, P < .001).
Teeth at advanced developmental stages transplanted to surgically created sockets show an impaired postoperative root development. A possible explanation might be damage of Hertwig's epithelial root sheath during the transplantation procedure.
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ABSTRACT: Conventional orthodontic traction may not be the treatment of choice in cases of inverted impaction of a maxillary incisor, especially when located near the alveolar crest. Poor prognosis is associated with the limited space for proper root development, resulting in a root too short for normal function and/or a severely dilacerated root interrupting the force-induced positioning. The surgical repositioning of ectopic impacted toothgerm before the development of root could be a valuable alternative choice of treatment before the decision of extraction. In this case report, an impacted immature incisor toothgerm in complete inversion was surgically repositioned using a closed-flap technique in a boy who was 6 years 8 months old. Continued root formation and spontaneous eruption were observed after surgery over the 51-month follow-up period, without pulpal or periodontal complications.Oral surgery, oral medicine, oral pathology and oral radiology. 07/2012;
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ABSTRACT: Abstract Objectives. This retrospective clinical study aimed to determine the success rate of autotransplanted impacted or retained teeth along with a patient satisfaction survey and to analyze the influence of relevant clinical and radiographic parameters. Subjects and methods. Fifty-seven teeth (37 canines, 10 molars, seven premolars, three incisors) in 45 patients (median 15 years) were evaluated over a mean of 1.6 years. The success criteria were pocket probing depth ≤3.5 mm, mobility grade ≤ II, Periotest ≤30 and complete alveolar bone healing. The influencing parameters were oral hygiene, smoking, periodontal screening index, occlusal/proximal contacts, horizontal position, dental age, pulp obliteration and degree of displacement. Furthermore, bone height was measured. Results. The overall success rate was 74%, along with a high patient satisfaction. The survival rate was 96% after a mean follow-up of 1.6 years. The favorable factors were proper oral hygiene, non-smoking, good general periodontal condition, proximal contacts and pulp obliteration. An increase in or maintenance of bone level was found in 96%. Conclusions. Autotransplantation of impacted or retained teeth is an appropriate treatment, if orthodontic alignment has failed, especially in growing patients.Acta odontologica Scandinavica 05/2013; · 1.41 Impact Factor
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ABSTRACT: Objective: To observe the periodontal healing of autogenously transplanted teeth loaded orthodontically after autotransplantation in Beagle dogs. Methods: Forty-eight teeth were autogenously transplanted, 24 of which were loaded postoperatively with orthodontic force at different time points and for different durations. Periodontal healing was evaluated by probing pocket depth (PPD), the expression of relevant proteins, and histomorphometric analyses. Results: The dental pockets of loaded and non-loaded teeth were both much deeper after the first postoperative week than before transplantation (P<0.05). Later, the PPD, which was measured after postoperative weeks 1, 3, 5, 9 and 13, gradually became shallow. The expressions of alkaline phosphatase (ALP) and basic fibroblast growth factor (bFGF) were higher in loaded teeth than in non-loaded teeth (P<0.05), and in groups subjected to two weeks duration of loading than in other groups at the same load time point (P<0.05). For the same load duration, the expressions of ALP and bFGF in teeth loaded after postoperative week 4 were higher than those of other treatments (P<0.05). According to histomorphometric analyses, an orthodontic force on transplanted teeth applied after postoperative weeks 4 or 8 for two weeks duration should be favorable for periodontal healing. Conclusions: It is advisable to apply an appropriate magnitude of force on autotransplanted teeth, such as orthodontic force, at appropriate time points and for a suitable duration, to achieve the optimal clinical prognosis following autogenous tooth transplantation. These results may serve as a basis for subsequent studies in humans so as to make clinical improvements.Journal of Zhejiang University SCIENCE B 11/2013; 14(11):1025-32. · 1.11 Impact Factor