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Autotransplantation of teeth
Abstract
Dental autotransplantation is the surgical transposition of a tooth from its original site to another site to replace a lost or compromised tooth in the same individual.1 It offers a method for replacing missing teeth or avulsed and traumatized teeth, particularly in children and adolescents. This surgical therapy is often overlooked as a treatment option by dentists and oral surgeons, who typically treat space closure by placing dental implants or bridges despite the fact that recent autotransplantation studies show high survival rates and success rates of 91.3%.2 Most tooth losses due to traumatic incidents occur in young patients, and implant placement is contraindicated until the completion of growth. In cases where there is no donor dilemma, and if a suitable graft is available, autotransplantation may be the therapy of choice.
... Autologous tooth transplantation can be divided into three categories: traditional transplantation, surgical extrusion and intentional replantation [1,2]. Traditional transplantation replaces teeth that cannot be preserved by transferring impacted or developing teeth from the donor site to the surgically prepared recipient site [3]. ...
Traditional transplantation, surgical extrusion and intentional replantation procedures are important treatment options that clinicians may consider performing in their daily clinical practice. There should be a well-constructed treatment plan for teeth with problems. In this paper, we present a series of case reports on three treatment methods used in autologous tooth transplantation and a literature review on the prevention of postoperative complications and the advantages of autologous tooth transplantation compared to dental implantation. The purpose of this study was to improve the understanding of autologous tooth transplantation.
... Autogenous tooth transplantation (ATT), or autotransplantation, is the surgical movement in one individual of a vital or endodontically treated tooth from its original location in the mouth to another site [1,2]. Tooth loss as a result of dental caries along with trauma is the most common indication, especially when mandibular and maxillary first molars are involved. ...
Background:
Autotransplantation is the surgical repositioning of a tooth within the same patient. It can be thought of as the controlled avulsion and re-implantation of a tooth and can be a viable alternative to other dental rehabilitation options. This review aimed to evaluate the survival rate (SR), major complications such as ankylosis rate (AR) and infection-related root resorption (RR), and overall success and failure rate (FR) in autotransplanted teeth.
Methods:
Six databases were accessed up to January 2021 to obtain all systematic reviews and meta-analyses (SRs and MAs).
Study selection:
After title and abstract reading, data extraction was performed from eligible SRs. The methodological quality was calculated for the included SRs using the risk of bias in systematic reviews (ROBIS) tool.
Results:
Six SRs were included in this review. The overall failure rate ranged from as low as 2.0% to 10.32%. The 1-year survival was very high (97.4-98.0%). The 5-year survival rate ranged from 81 to 98.2%. Major complications of AR ranged from 1.2 to 6.2%, and RR ranged from 2.1 to 10.4%.
Conclusion:
The overall findings from these SR and MA are promising; however, all the SRs include only single-arm prospective or retrospective studies, the SRs are of overall low methodological quality, and for the heterogeneity of the included SRs, well-designed comparative studies with a long-term follow-up are recommended.
... ATT refers to the transplantation of physically intact tooth without biological function, such as impacted, dislocated or ectopic tooth, from one position to another to support the masticatory function of the affected tooth. ATT is most commonly used in the third molar to replace the damaged first or second molar [3]. ATT requires a complete extraction of the donor tooth without any damage or cracks, and the periodontal ligament (PDL) on the root surface needs to be preserved, which is a critical problem affecting the prognosis of the donor tooth [4]. ...
Objective
The 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.
Methods
A 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.
Results
Average 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.
Conclusions
The 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.
... Currently, the most common treatments when a dental absence is faced are removable prostheses, implants or orthodontics. However, there is another less known option called dental autotransplantation, a promising alternative, especially in young patients, where the treatments mentioned above may not be suitable or cannot be performed [1][2][3][4][5][6][7]. This technique has various advantages compared with conventional methods, such as the use of autologous tissue to preserve the periodontal ligament, the preservation of the masticatory function and the favorable aesthetic results [1][2][3][4]. ...
Dental autotransplantation is the process by which a tooth located in its natural socket is extracted and relocated to another socket in which the tooth is missing or has been extracted due to various reasons such as trauma, extensive caries or periapical pathology, among other reasons. This proposed technique offers a more conservative alternative for patients in comparison with prosthetic or implant techniques, especially in young patients where implants are contraindicated until their maxillary bone system’s growth ends. Thus, the objective of this review was to present a qualitative synthesis of the risk factors that influence the results of open apex dental autotransplantation in humans. After confirming that there are various factors that influence dental autotransplantation, it was concluded that the extra-alveolar time of the donor tooth and the periodontal damage of the root of the donor tooth are the factors of greatest interest in the literature, both closely linked to the use of 3D replication of the transplanted tooth.
Auto transplantation is a fast and economical option when a suitable donor tooth is available for replacement of a tooth considered impossible to treat. The purpose of this case report is to describe methods used for autotransplantation and its advantages for cases with a missing bilateral mandibular firstmolar, as compared with a dental implant, removable partial denture, and other methods of prosthesis. In the present patient who underwent auto transplantation, clinical and radiographic outcomes were considered satisfactory at one and two years postoperatively. Bone healing was observed around the roots of transplanted teeth, which showed good function. In autotransplantation cases, even when the donor tooth has complete root formation, a high success rate can be achieved when the patient is properly selected and treated. Although the chance of root resorption remains because of necrotic pulp and periodontal irritation during manipulation, auto transplantation should be considered as a good treatment modality in feasible cases. Based on the present findings, even though autotransplantation is not common in general dental practice, we consider that it offers a clinically and economically viable alternative as compared to other more complicated prosthetic and dental implant treatments. The purpose of this report is to show that auto transplantation is a superior treatment method for single molar defects as compared to other prosthetic methods, as the periodontal ligament of the patient can be used and cutting adjacent teeth is avoided. In addition, it is a treatment method that can effectively utilize a wisdom tooth.
Objective: This study aimed to investigate the effectiveness and feasibility of the use of extra-oral apicoectomy combined with retrograde filling for the sealing of root canal system without root canal therapy in the process of autotransplantation of tooth（ATT） .
Materials and methods: Patients receiving autologous tooth transplantation in the Department of Oral Surgery, Hospital of Stomatology, Wuhan University from 2019 to 2020 were screened. A total 22 patients were included. All the roots of the donor tooth were fractured during tooth extraction, and root canal therapy was not performed temporarily after repairing the broken end and retrograde filling with iRoot BP plus. The periodontal status of the donor teeth 1–2 years after operation was studied, and CBCT was used to assess the presence of ankylosis, internal or external resorption of tooth, periodontitis, periapical periodontitis and omission of canal closure.
Results: 22 transplanted teeth of 22 cases were all capable of chewing, and 4 of them had adverse clinical or radiographic findings. Results show a retention rate of 100% and success rate of 81.8%. These figures are consistent with the success and retention rates of the traditional autotransplantation. 63.6% of patients were able to chew hard objects with the planted teeth, and 45.4% of the cases had food impaction.the chewing efficiency of the patient's transplanted teeth side accounted for an average of 82.0% on the healthy side.
Conclusion: The extra-oral apicoectomy combined with retrograde filling of the transplanted teeth yielded good results．
Clinical Revelance: In some special cases such as when the complex root canal system of the donor teeth cannot guarantee perfect root canal therapy, extra-oral apicoectomy and retrograde filling to seal the root canal system may be an alternative for patients with autogenous tooth transplantation.
Tooth autotransplantation, that is the surgical movement of a tooth from its original location to another site within the same person, is an alternative to dental implantation because it can save time, provide faster healing and function, and has esthetic advantages. A unique sensory system can be maintained, and the procedure promotes proper healing of the periodontal environment. We report on a case of external dental fistula with apical periodontitis, in which immediate tooth autotransplantation of the right mandibular posterior tooth (tooth 47) was performed with a favorable outcome 6 years postoperatively. An important advantage of this procedure is that the transplanted tooth functions early at the recipient site and this procedure is minimally invasive therapy for apical periodontitis of mandibular molars accompanied with an external dental fistula.
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