João Batista Gagno Intra’s research while affiliated with Associação Brasileira de Odontologia and other places

Introduction The aim of this study was to evaluate root development in autotransplanted teeth using cone‐beam computed tomography (CBCT) images. Methods Twelve premolars with incomplete root formation, which were selected to replace prematurely lost upper central incisors, were analyzed by CBCT on two different occasions. The first CBCT examination (T1) was conducted before tooth autotransplantation. The second CBCT examination (T2) was performed over a follow‐up period of at least 12 months and < 5 years. Three previously calibrated evaluators assessed root development. The positions of the tomographic planes were standardized. The mean root length in sagittal and coronal tomographic sections was used to validate the root length at T1 and T2. Longitudinal root development of the transplanted tooth was determined by calculating the difference in root length between T2 and T1. The intraclass correlation coefficient (ICC), paired t ‐test, and Pearson test were applied, with significance set at 5%. Results The mean time elapsed between T1 and T2 was 962 days/2.6 years. The ICC was > 0.75. The measurements obtained at T2 were significantly greater than at T1 ( p = 0.001). The mean increase in root length was 2.83 mm. There was no significant correlation ( p = 0.413; r = 0.261) between root length increase and the time elapsed between T1 and T2. Conclusion Premolar teeth with incompletely formed roots transplanted to the upper central incisor region showed continued root development during postoperative follow‐up.

Introdução: O escurecimento dentário pode ser o primeiro sinal clínico de necrose pulpar asséptica, confirmada por testes de sensibilidade. Imagiologicamente, em exames a cada três meses, pode-se detectar precocemente as consequências da necrose pulpar asséptica não diagnosticada e tratada, como o desenvolvimento de lesão periapical crônica e reabsorções apicais externas inflamatórias. Objetivo: A partir de um caso clínico clássico, objetivou-se ressaltar a importância do traumatismo dentário tipo subluxação e concussão como causa da necrose pulpar asséptica e, se não diagnosticada e tratada, de lesões periapicais crônicas. Caso clínico: Paciente com 14 anos de idade, praticante de basquetebol, o qual, após um ano da subluxação, detectou a lesão periapical crônica com reabsorção apical externa inflamatória, além de um discreto escurecimento coronário. Conclusão: Com a adoção de um protocolo para acompanhamento e controle clínico, pode-se interceptar a maior parte das consequências dos traumatismos dentários tipo concussão e subluxação, especialmente quando o diagnóstico é feito o mais precocemente possível.

Aim: The aim of this retrospective study was to evaluate the post-surgical results of autotransplanted teeth, considering the pulp survival rate and periodontal healing. Methodology: Records of 43 patients with 50 autotransplanted teeth were analysed. Demographic, clinical and radiographic data were verified. The time between autotransplantation surgery and the date of endodontic access was considered to assess the pulp survival rate. Periodontal healing was observed through gingival morphology and the presence of root resorption. Pulp survival was verified and the influence of Nolla stage on the survival rate was analysed. Results: The pulp survival rate was 72%, and the stage of root development influenced the survival rate in autotransplanted teeth (p = 0.001). The pulp survival rate in autotransplanted teeth in Nolla stages 6 and 7 was 100%; the pulp survival rate for teeth in stages 8 and 9 was 90% and 75%, respectively. Regarding periodontal analysis, no tooth was observed in the presence of periodontal pockets and mobility above grade I. Replacement resorption was diagnosed in 20% and external inflammatory resorption in 4%. Conclusions: Dental autotransplantation was a safe treatment, showing satisfactory results. The pulp survival rate was considered high, especially in teeth with incomplete rhizogenesis.

Aim To evaluate a sample consisting of 144 autotransplanted teeth performed in 128 patients, which were subjected to periodic follow‐up from 6 months to 23 years. Materials and methods The sample consists of 33 molars, 91 premolars, 4 canines and 16 incisors. Clinical and radiographic examinations were performed every 6 months since the day of transplantation. In the last follow‐up visit, successful autotransplantation should present the following: absence of active inflammatory root resorption and ankylosis; crown/root ratio <1 (root size higher than crown size); radiographic evidence of additional root growth (in case of partly formed root grafts); absence of tooth mobility, periodontal disease and persistent periapical lesions after endodontic treatment. The success rate was acquired by percentage of transplanted teeth that met the criteria in relation to the total number of transplanted teeth in the sample. Statistical tests were performed as indicators of success. Results The evaluation showed a 93% success rate for the completion of autotransplanted teeth. Eight teeth showed inflammatory root resorption and five teeth, ankylosis. The success rate of molars was 91% and canines was 100%. All variables presented statistical p value of <0.05, except for tooth colouration, root development, donor site and recipient site. Conclusion These findings support that tooth autotransplantation is a reliable treatment and preferred solution for early tooth loss in children and young patients. Furthermore, it demands the professionals the correct evaluation as well as to create the necessary conditions regarding the site receptor, tooth to be transplanted, quality of the surgical procedure, aesthetic complement and periodic control of each case.

Introduction The aim of this retrospective study was to assess the success, survival rate, and soft tissue esthetic of autotransplanted teeth. Methods This study included patients with at least 1 tooth autotransplanted to the maxilla during childhood or adolescence. The autotransplantation technique included the removal of an immature tooth from a donor site and its placement in the maxilla as a replacement for a missing or extremely compromised tooth. The cases were properly restored to assure function and esthetic. To be considered successful, the tooth should be asymptomatic at the time of assessment, no pain to palpation and percussion, have no signs of apical periodontitis or sinus tract, have a periodontal probe ≤ 3, and have an absence of root resorption and development of at least 70% of the normal root. The esthetic evaluation of the soft tissue was based on the Pink Esthetic Score (PES) and graded as very unsatisfactory, unsatisfactory, poor, fair, good, or excellent. Data were statistically analyzed at a significance level of 5%. Results Thirty-five patients (23 male and 12 female) had 43 anterior teeth replaced, including 42 central incisors and one lateral incisor. The follow-up period ranged from 1 year to 25 years. In regard to success and survival rate, 43 teeth were assessed; 34 cases (79.07%) were considered successful and 9 (20.93%) unsuccessful. Only 1 tooth was lost, and 42 teeth remained functional (survival rate 97.67%). In regard to the esthetic, 40 teeth could be assessed and were considered as excellent (30%), good (35%), fair (27.5%), and poor (7.5%); there were no reports of unsatisfactory or very unsatisfactory cases. Conclusions Tooth autotransplantation can be considered a valid procedure to replace lost teeth in the maxilla, presenting high survival and success rates. The overall esthetic of the patients was considered as satisfactory.

Ultra-som; Retentor intra-radicular; Retratamento.

Retropreparo; Cirurgia pareododôntica; Instrumentação ultra-sônica.

Periapicopatias; Lesões periapicais; Dentes unirradiculados; Terapia endodôntica.