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Naros A, Schulz M, Finke H, Reinert S, Krimmel M. Autologous Tooth Transplantation in Craniofacial Malformations. Cleft Palate Craniofac J 2023:10556656231170997. [PMID: 37093752 DOI: 10.1177/10556656231170997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVE To evaluate the applicability of transplanted teeth in young patients with craniofacial anomalies. DESIGN Observational study. SETTING Comprehensive Centre for Cleft Palate and Craniofacial Malformations. PATIENTS/PARTICIPANTS Patients with craniofacial anomalies who underwent tooth transplantation. Only children with complete clinical and radiological documentation and a follow-up period of at least 1.5 years were included. INTERVENTIONS Tooth transplantation. MAIN OUTCOME MEASURE(S) Retrospective evaluation of clinical records, pre- and postoperative radiographs, and operative charts. Clinical characteristics of patients, preoperative parameters and postoperative outcome parameters were collected. RESULTS A total of 17 patients with 23 tooth transplantations were included. The median follow-up period was 6.7 years. The pooled survival and success rates were 91%. Notably, one out of two teeth that were transplanted into the bone grafted alveolar cleft site had to be extracted, which might indicating a higher risk for this procedure. In total, two transplanted teeth had to be extracted during the follow-up period, one due to external resorption and the other one due to perio-endo lesion. One patient needed endodontic treatment due to pulp necrosis. CONCLUSION We consider tooth transplantation to be a reliable and suitable procedure in the dental rehabilitation of young patients with craniofacial anomalies and fitting concomitant circumstances. We encourage craniofacial teams to reconsider this option more frequently in appropriate cases.
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Affiliation(s)
- Andreas Naros
- Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
| | - Matthias Schulz
- Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
| | - Hannah Finke
- Department of Orthodontics, Tübingen University Hospital, Tübingen, Germany
| | - Siegmar Reinert
- Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
| | - Michael Krimmel
- Department of Oral and Maxillofacial Surgery, Tübingen University Hospital, Tübingen, Germany
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Influence of Static Navigation Technique on the Accuracy of Autotransplanted Teeth in Surgically Created Sockets. J Clin Med 2022; 11:jcm11041012. [PMID: 35207285 PMCID: PMC8879114 DOI: 10.3390/jcm11041012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to analyse and compare the position of single-rooted autotransplanted teeth using computer-aided SNT drilling and conventional freehand (FT) drilling, by comparing the planned and performed position at the coronal, apical and angular level. Materials and methods: Forty single-root upper teeth were selected and distributed into the following study groups: A. Autotransplanted tooth using the computer-aided static navigation technique (SNT) (n = 20) and B. Autotransplanted tooth using the conventional free-hand technique (FT) (n = 20). Afterwards, the teeth were embedded into two experimental models and 10 single-root upper teeth were randomly autotransplanted in each experimental model. The experimental models were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan, in addition to a postoperative CBCT scan, after the autotransplantation. Datasets from postoperative CBCT scans of the two study groups were uploaded to the 3D implant planning software, aligned with the autotransplantation planning, and the coronal, apical and angular deviations were measured. The results were analysed using Student’s t-test and Mann–Whitney non-parametric statistical analysis. Results: Coronal (p = 0.079) and angular (p = 0.208) statistical comparisons did not present statistically significant differences; however, statistically significant differences between the apical deviation of the SNT and FT study groups (p = 0.038) were also observed. Conclusions: The computer-aided static navigation technique does not provide higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique.
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Dioguardi M, Quarta C, Sovereto D, Troiano G, Melillo M, Di Cosola M, Cazzolla AP, Laino L, Lo Muzio L. Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review. Bioengineering (Basel) 2021; 8:120. [PMID: 34562942 PMCID: PMC8468762 DOI: 10.3390/bioengineering8090120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success. MATERIALS AND METHODS This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases-PubMed, Scopus and Google Scholar-by two independent reviewers following the PRISMA protocol, from which 599 records were identified. CONCLUSIONS Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Cristian Quarta
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Michele Melillo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Angela Pia Cazzolla
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (D.S.); (G.T.); (M.M.); (M.D.C.); (A.P.C.); (L.L.M.)
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Sato M, Garcia-Sanchez A, Sanchez S, Chen IP. Use of 3-dimensional-Printed Guide in Hemisection and Autotransplantation of a Fusion Tooth: A Case Report. J Endod 2021; 47:526-531. [PMID: 33352149 DOI: 10.1016/j.joen.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023]
Abstract
Three-dimensional (3D)-printed guides have been used in endodontics to prepare a conservative access, locate calcified or missing canals, and perform precisive osteotomy in apicoectomy. Here, we present the treatment of a fusion tooth by combining 3D printing technology and endodontic intervention in a 10-year-old patient. The bifid crown of a maxillary right lateral incisor #7 had caused esthetic concerns and malocclusion. Clinical and radiographic examinations showed that #7 is fused with a supernumerary tooth with 2 independent root canals. The fusion involved the entire crown and the coronal and middle roots. Because of financial constraints, a multidisciplinary approach involving endodontic, orthodontic, and prosthodontic treatment was excluded. We hemisectioned the tooth intraorally with a 3D-printed guide, extracted the supernumerary tooth, and transplanted tooth #7 to a position with improved esthetics and occlusion. A 3D-printed tooth replica was used to prepare the recipient site for autotransplantation. At the 6-month follow-up, tooth #7 was diagnosed with pulp necrosis and asymptomatic apical periodontitis. Root canal treatment of tooth #7 was completed, and osseous healing was observed 8 months later. The patient had no clinical symptoms and was satisfied with the outcome 14 months after hemisection and transplantation. The open space between teeth #7 and #8 was closed without orthodontic treatment. We present an alternative option to treat a fusion tooth in young patients who do not opt for other treatment options because of their stage of development or for socio-economic reasons. Techniques in modern endodontics, such as cone-beam computed tomographic imaging and 3D printing, should be adapted when it is beneficial to patients.
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Affiliation(s)
- Manuel Sato
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut
| | - Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut
| | - Sergio Sanchez
- Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut
| | - I-Ping Chen
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut.
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Erdem NF, Gümüşer Z. Retrospective Evaluation of Immediate Impacted Third Molars Autotransplantation After Extractions of Mandibular First and/or Second Molars With Chronic Periapical Lesions. J Oral Maxillofac Surg 2020; 79:37-48. [PMID: 32926867 DOI: 10.1016/j.joms.2020.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the success rate of simultaneous autotransplantation of the immature impacted third molars with the guidance of computer-aided rapid prototyping (CARP) to the place of mandibular first or second molars with extraction indication due to the untreatable radiographic periapical lesions. PATIENTS AND METHODS Twelve radiographically and clinically hopeless mandibular first or second molars with periapical lesions of 10 patients between the ages of 15 to 21 were included in this retrospective clinical study. Cone-beam computed tomography (CBCT) images were used to produce the CARP models of the donor impacted third molars. Following the extractions of the mandibular first or second molars with periapical lesions, sockets were curetted and prepared with proper burs until a suitable infraocclusal fit of the CARP models. The donor teeth were transplanted synchronously with their surgical extractions. Postoperatively patients were followed clinically and radiographically in the 3rd and 6th months and every 6th month thereafter for at least 18 months. Clinically, the mobility, periodontal plaque, bleeding on probing, percussion sensitivity, periodontal pocket, vitality, and occlusion, and radiographically, the root resorption, ankylosis, presence of lamina dura, and healing of periapical lesion were assessed. RESULT By the end of 12th month, and thereafter, all transplanted teeth were in occlusion and functioning properly with no clinical or radiological signs of pathology. All of the autotransplantation cases involved in this clinical study were successful within a mean follow-up period of 20.4 months with the least one of 18 months. CONCLUSION Immediate autotransplantation of the immature third molars to the place of mandibular first or second molars with extraction indication due to the periapical lesion can be a proper treatment option for adolescent patients.
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Affiliation(s)
- Necip Fazıl Erdem
- Asistant Professor, Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, Istanbul, Turkey.
| | - Zeynep Gümüşer
- Resident, Department of Oral and Maxillofacial Surgery, Marmara University, School of Dentistry, Istanbul, Turkey
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Orthodontic management of patients with congenitally missing permanent teeth. BALKAN JOURNAL OF DENTAL MEDICINE 2020. [DOI: 10.2478/bjdm-2020-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dental agenesis is one of the most common developmental anomalies in humans. It occurs as part of a genetic syndrome or as an isolated sporadic or familial finding. Third molars, second mandibular premolars and maxillary lateral incisors are the most frequently targeted teeth of the permanent dentition. Clinically, patients with congenitally missing permanent teeth seeking treatment present with unesthetic diastemas, midline deviation and tilting of adjacent teeth in the edentulous areas. The impact of tooth agenesis reflects on esthetics, function, psychological and social well-being of the individuals affected. Orthodontics can contribute to the treatment plan selected by rearranging the present teeth so as to open spaces for prosthetic restorations or close spaces by reshaping teeth if needed. Following orthodontic space opening/maintaining, the usual alternatives involve single implants, two-(cantilever) or full coverage(cantilever) prostheses. Less frequently, the treatment modality of autotransplantation is proposed with a good esthetic result but feasible only in young patients where the roots of the premolars are still developing. In orthodontic space closure, treatment is accomplished sooner without waiting for the completion of growth of the patient. Depending on various factors such as the malocclusion, the dento-skeletal profile, the smile line, the space requirements, the teeth missing, the periodontal issues, the age of the patient and any financial issues, the clinician will determine the most appropriate treatment approach. The final esthetic and functional result should resemble an intact natural dentition.
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Abstract
INTRODUCTION Autotransplantation is a surgical method in which a tooth is repositioned within the same patient. It can be described as a controlled reimplantation of an extracted tooth into a new, surgically prepared socket. The key to success of this treatment is the preservation and regeneration of the periodontal ligament. It is an underutilized technique which, if conducted with a multidisciplinary team, can be an ideal treatment option for patients with failing or missing teeth. OBJECTIVES The detailed clinical procedures, indications for this technique, and the factors affecting its success are discussed.
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Affiliation(s)
- Racha Hariri
- Department of Orthodontics, Faculty of Dental Surgery, University of Marmara, Istanbul, Turkey
| | - Emad Eddin M. Alzoubi
- Department of Orthodontics, Faculty of Dental Surgery, University of Malta Medical School, Mater Dei Hospital, Msida, Malta
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Grisar K, Chaabouni D, Romero LPG, Vandendriessche T, Politis C, Jacobs R. Autogenous transalveolar transplantation of maxillary canines: a systematic review and meta-analysis. Eur J Orthod 2019; 40:608-616. [PMID: 29860316 PMCID: PMC6265659 DOI: 10.1093/ejo/cjy026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background and objectives The objective was to systematically review transalveolar transplantation of maxillary canines and the long-term outcome for an average follow-up period of 2 years or more. Data collection and analysis A systematic review of the currently available literature until December 2017 was conducted, using Medline, Cochrane Central, Web off Science, and PubMed. Articles were screened for 1. indications, 2. contra-indications, 3. surgical planning, 4. surgical technique, 5. associated risk factors, and 6. long-term outcome for transalveolar transplantation of maxillary canines with the following outcome measures: bone-related outcomes, tooth-related outcomes, soft tissue-related outcomes, and aesthetic outcome measures. Descriptive statistics, as well as a quality assessment of included articles, were performed. Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the Methodological index for non-randomized studies (MINORS). Results Twelve articles were included in this review. These studies included outcome data for 783 autotransplanted maxillary canines, with long-term studies indicating a clinically acceptable overall outcome. Limitations Since the lack of randomized controlled trials considering this topic, the quality of the evidence in the present review is considered low. However, impacted maxillary canines are a rare anomaly and different aspects, such as position of the impacted canine, patient’s age and patient’s demands, and expectancies must be taken into account, it is practically impossible to randomize treatment. Conclusions There is sufficient evidence to justify the transalveolar transplantation of maxillary canines as a legitimate treatment technique for impacted maxillary canines deemed difficult to treat with surgical exposure and subsequent orthodontic alignment. Long-term studies have shown that a good overall outcome is to be expected. There is no clear agreement in the literature on the indications and contra-indications for transalveolar transplantation of maxillary canines. Implication of key findings It is highly desirable that further research on this issue be undertaken, high-quality observational studies are recommended. Registration PROSPERO (CRD42017056348)
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Dorra Chaabouni
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium.,Department of Radiology, University Dental Clinic, Monastir, Tunisia
| | - Lesly Paola Gaitan Romero
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | | | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Grisar K, Vanpoecke J, Raes M, Albdour EA, Willems G, Politis C, Jacobs R. Development and validation of the autotransplanted maxillary canine radiological index. Clin Exp Dent Res 2018; 4:167-173. [PMID: 30386638 PMCID: PMC6203832 DOI: 10.1002/cre2.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 11/11/2022] Open
Abstract
The purpose of this study was to propose and validate an index evaluating 2D and 3D radiographic variables of autotransplanted maxillary canines. Setting and sample population are from the Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Eight oral-maxillofacial surgeons rated 12 autotransplanted maxillary canines and adjacent bone using 11 rating variables. A new autotransplanted maxillary canine radiological index (AMCRI) was proposed. It consisted of 11 variables. These variables were based on 2D (intraoral) and 3D Cone Beam Computed Tomography (CBCT) radiographs. Intraclass correlation coefficient (ICC) and Fleiss's kappa statistics were performed to analyze intrarater and interrater agreement. Considering cumulative assessment of the AMCRI, the mean ICC value for the interrater agreement of the eight examiners was 0.94, representing an excellent agreement. Intrarater agreement was 0.91. The AMCRI is an objective tool in rating radiological outcome of autotransplanted canines and adjacent bone, when compared with the contralateral canine.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Jasper Vanpoecke
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Margot Raes
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Emad Ali Albdour
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Guy Willems
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
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Outcome of Autotransplantation of Mature Third Molars Using 3-dimensional-printed Guiding Templates and Donor Tooth Replicas. J Endod 2018; 44:1567-1574. [PMID: 30154002 DOI: 10.1016/j.joen.2018.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 11/21/2022]
Abstract
Autotransplantation exhibits a number of advantages compared with other treatment options (ie, dental implants or fixed partial prostheses), such as greater resistance to occlusal loading, maintenance of the periodontal ligament and surrounding bone, and the potential for better esthetics. The aim of this study was to determine clinical outcomes for autotransplanted teeth with complete root formation using 3-dimensional-printed guiding templates and tooth replicas. Twenty-seven third molars with completely formed roots were autotransplanted. Each donor tooth and recipient site were examined clinically and radiographically (periapical radiographs). A selective cone-beam computed tomographic scan was taken of each donor tooth and recipient site. The images of the selected donor teeth were segmented and saved as stereolithography files. Similar to virtual planning of dental implants, correct angulation, rotation, and accurate positioning of the donor teeth were predefined using the stereolithography files. According to the virtually defined positions and dimensions of the donor teeth, 3-dimensional guiding templates and donor tooth replicas were printed. All autotransplantations were performed according to 1 treatment protocol and surgical technique. In 22 of the 24 transplanted teeth, no inflammation occurred during the healing period. At 2 years, no pathologic radiolucency or tooth resorption was observed in the 22 donor teeth. The autotransplanted teeth fulfilled the success criteria in 22 cases for a 91.7% success rate. Digital planning could potentially provide an accurate alternative to current autotransplantation techniques.
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Rohof ECM, Kerdijk W, Jansma J, Livas C, Ren Y. Autotransplantation of teeth with incomplete root formation: a systematic review and meta-analysis. Clin Oral Investig 2018; 22:1613-1624. [PMID: 29525924 PMCID: PMC5906482 DOI: 10.1007/s00784-018-2408-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 03/01/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objective of this systematic review and meta-analysis was to determine the rates of survival and success and the complications related to autotransplantation of teeth with incomplete root formation. Additionally, we attempted to identify the prognostic factors that influence the outcome of tooth autotransplantation. MATERIALS AND METHODS A literature search for all data published until July 2016 was conducted. Inclusion and exclusion criteria were specified. Risk of bias was assessed with the Newcastle checklist. Meta-analysis was performed by using the DerSimonian-Laird random effect model. The 1-, 5-, and 10-year survival rates and the weighted estimated survival, success, and complication rates per year were calculated. RESULTS Thirty-two studies were included for analysis. The survival rates reported after 1, 5, and 10 years were 97.4, 97.8, and 96.3%, respectively. The annual weighted estimated survival rate (98.2%), success rate (96.6%), and complication rates in terms of ankylosis (2.0%), root resorption (2.9%), and pulp necrosis (3.3%) were analyzed. No firm conclusions could be drawn with respect to the prognostic factors due to insufficient evidence of high quality. CONCLUSION The survival and success rates of autotransplantation of teeth with incomplete root formation were high (> 95%), with a low rate of complications (< 5%). CLINICAL RELEVANCE Current evidence from the literature on autotransplantation of teeth with incomplete root formation shows favorable survival and success rates and low complication rates, indicating it is a reliable treatment option.
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Affiliation(s)
- Evelyn C M Rohof
- Department of Orthodontics, University Medical Center Groningen, Hanzeplein 1 - BB72, NL, 9700 RB, Groningen, The Netherlands
| | - Wouter Kerdijk
- Department of Public and Individual Oral Health, Center for Dentistry and Oral Hygiene University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan Jansma
- Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Yijin Ren
- Department of Orthodontics, University Medical Center Groningen, Hanzeplein 1 - BB72, NL, 9700 RB, Groningen, The Netherlands.
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Autotransplantation and Orthodontic Treatment after Maxillary Central Incisor Region Trauma: A 13-Year Follow-Up Case Report Study. Case Rep Dent 2018; 2018:2039714. [PMID: 29581900 PMCID: PMC5822928 DOI: 10.1155/2018/2039714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/26/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022] Open
Abstract
The anterior maxilla is the most prone region to the trauma during childhood, and tooth loss sometimes happens due to trauma. Replacing the missing teeth has always been one of the dentists' challenges in children and adolescents, since their dentofacial growth is not complete. Autotransplantation of mandibular premolars with two-thirds or three-quarters of root formation provides the best prognosis for the tooth survival. This case report describes the management of a 10-year-old boy suffering a severe dental injury who received the autotransplantation of the premolars from mandible to restore the space caused by trauma in maxillary central incisor region and a 13-year follow-up of the autotransplantation.
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Abstract
Maxillary canines are the most commonly impacted teeth, second only to third molars. Various treatment methods may be used to recover impacted maxillary canines. This is a report of a 14-year-old girl with a severely malpositioned impacted right maxillary canine which accompanied severe root resorption of adjacent tooth, treated by autotransplantation with a computer aided rapid prototyping model as a surgical guide. This case report demonstrates that autotransplantation can be a reliable treatment alternative, in cases with a severely malpositioned impacted canine, providing acceptable prognosis.
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Padwa BL, Dang RR, Resnick CM. Surgical Uprighting Is a Successful Procedure for Management of Impacted Mandibular Second Molars. J Oral Maxillofac Surg 2017; 75:1581-1590. [DOI: 10.1016/j.joms.2017.02.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/28/2017] [Accepted: 02/21/2017] [Indexed: 11/16/2022]
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Yu HJ, Jia P, Lv Z, Qiu LX. Autotransplantation of third molars with completely formed roots into surgically created sockets and fresh extraction sockets: a 10-year comparative study. Int J Oral Maxillofac Surg 2017; 46:531-538. [PMID: 28062250 DOI: 10.1016/j.ijom.2016.12.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study was to analyze and compare the long-term clinical outcomes of mature third molar autotransplantation in surgically created sockets and fresh extraction sockets with regard to survival and functional success rates. A total of 65 third molars with completely formed roots were autotransplanted in 60 patients (average age 33.1 years). Thirty-six of the teeth were autotransplanted into surgically created sockets with or without guided bone regeneration (GBR; delayed autotransplantation), while 29 were autotransplanted into fresh extraction sockets (immediate autotransplantation; control group). All patients underwent annual clinical and radiographic examinations (average follow-up 9.9 years, range 7-13 years). The survival rates for the control, GBR, and no GBR groups were 93.1%, 95.2%, and 80.0%, respectively, with no significant differences among the groups. There were no statistically significant differences among the groups with regard to the frequency of inflammatory root resorption or root ankylosis. Age did not influence the clinical outcomes. These results suggest that the autotransplantation of third molars with completely formed roots is effective in both surgically created and fresh extraction sockets and provides a high long-term success rate if cases are selected and treated appropriately.
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Affiliation(s)
- H J Yu
- Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - P Jia
- Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - Z Lv
- Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - L X Qiu
- Peking University School and Hospital of Stomatology, Haidian District, Beijing, China.
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Prado N, Malik O, Waring D. The Management of the Dilacerated Impacted Maxillary Central Incisor. DENTAL UPDATE 2016; 43:618-630. [PMID: 29148672 DOI: 10.12968/denu.2016.43.7.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The clinical problem of how best to manage a dilacerated, impacted maxillary central incisor will only be encountered rarely. The treatment aim should be to achieve results that are indistinguishable from normal appearance in a way that is appropriate for the patient. This article discusses the incidence of dilacerations in maxillary incisors and describes the treatment approaches available − orthodontic alignment or surgical removal and management of the resulting space, considering orthodontic repositioning, autotransplantation and various prosthetic replacements. Treatment indications, advantages and disadvantages, restorative and surgical implications, as well as the evidence-base relating to the various treatment modalities will be presented, along with clinical case examples. Clinical relevance: This paper discusses a problem that, if not managed appropriately, can lead to poor results for the patient. Even for practitioners who may not undertake the treatment mentioned, it will enable them to have more in-depth discussion with their patients should the situation arise.
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Verweij JP, Toxopeus EE, Fiocco M, Mensink G, van Merkesteyn JR. Success and survival of autotransplanted premolars and molars during short-term clinical follow-up. J Clin Periodontol 2016; 43:167-72. [DOI: 10.1111/jcpe.12492] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jop P. Verweij
- Department of Oral and Maxillofacial Surgery; Leiden University Medical Center; Leiden The Netherlands
| | - Elisabeth E. Toxopeus
- Department of Oral and Maxillofacial Surgery; Leiden University Medical Center; Leiden The Netherlands
| | - Marta Fiocco
- Department of Medical Statistics and Bioinformatics; Leiden University Medical Center; Leiden The Netherlands
- Mathematical Institute; Leiden University; Leiden The Netherlands
| | - Gertjan Mensink
- Department of Oral and Maxillofacial Surgery; Leiden University Medical Center; Leiden The Netherlands
- Department of Oral and Maxillofacial Surgery; Amphia Hospital; Breda The Netherlands
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Post-Odontoma autotransplantation of an impacted tooth: A case report. J Oral Biol Craniofac Res 2015; 5:120-3. [PMID: 26258027 DOI: 10.1016/j.jobcr.2015.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 02/06/2015] [Indexed: 10/23/2022] Open
Abstract
After years of relegation by dental implants, autotransplantation has recently become more popular because of a better understanding of its science. The prognosis of autotransplantation primarily depends upon the presence of an intact alveolar bone at the transplant site and the regeneration of a functional periodontal ligament of the transplant. Replacement of an unsalvaged or a missing tooth by a natural tooth with normal periodontium within a short duration of treatment is the ultimate challenge of autotransplantation. Meanwhile, Platelet Rich Fibrin (PRF) is popular as a biomaterial which helps in the regeneration of bone and periodontal tissues. To improve the prognosis, and also shorten the treatment time in a rare case of autotransplantation of an impacted tooth in a post-odontoma site, we did a two-stage surgical procedure aided by synthetic bone granules (Biograft) and PRF. The clinical and radiological findings at 6 months follow-up showed good result and promise.
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Almpani K, Papageorgiou SN, Papadopoulos MA. Autotransplantation of teeth in humans: a systematic review and meta-analysis. Clin Oral Investig 2015; 19:1157-79. [DOI: 10.1007/s00784-015-1473-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 04/05/2015] [Indexed: 11/29/2022]
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Mertens B, Boukari A, Tenenbaum H. Long-term follow up of post-surgical tooth autotransplantation: a retrospective study. ACTA ACUST UNITED AC 2014; 7:207-14. [DOI: 10.1111/jicd.12126] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Brenda Mertens
- Department of Periodontology; University of Strasbourg; Strasbourg France
| | | | - Henri Tenenbaum
- Department of Periodontology; University of Strasbourg; Strasbourg France
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Dharmani U, Rajput A, Kamal C, Talwar S, Verma M. Successful autotransplantation of a mature mesiodens to replace a traumatized maxillary central incisor. Int Endod J 2014; 48:619-26. [PMID: 25070115 DOI: 10.1111/iej.12347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 07/25/2014] [Indexed: 11/26/2022]
Abstract
AIM This case describes the successful transplantation of a mature mesiodens tooth to replace a traumatized maxillary central incisor. SUMMARY A 17-year-old male attended 1 week after a traumatic injury to his left maxillary central incisor (tooth 21). Radiographs revealed a horizontal root fracture and a poor prognosis. The tooth was atraumatically removed and replaced with a mesiodens lying in the same region. After stabilization, root canal treatment was performed and aesthetics were restored with a tooth coloured restoration. A 2-year follow-up revealed the tooth had good aesthetics and function. KEY LEARNING POINTS A supernumerary nonfunctional tooth such as a mesiodens can be successfully used to replace a missing permanent tooth by autotransplantation. Autotransplantation has a high success rate if case selection is good, appropriate surgery is carried out and excellent hygiene is maintained. Autotransplantation should be considered as one of the most biologic techniques for replacing a missing tooth with minimal cost. Autotransplantation can be carried out even after complete root formation in the donor tooth.
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Affiliation(s)
- U Dharmani
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - A Rajput
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - C Kamal
- Department of Pedodontics, College of Dental Education and Research, New Delhi, India
| | - S Talwar
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - M Verma
- Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Huth KC, Nazet M, Paschos E, Linsenmann R, Hickel R, Nolte D. Autotransplantation and surgical uprighting of impacted or retained teeth: A retrospective clinical study and evaluation of patient satisfaction. Acta Odontol Scand 2013; 71:1538-46. [PMID: 23638808 DOI: 10.3109/00016357.2013.775667] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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.
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Canine autotransplantation: effect of extraction site preservation with a titanium prosthesis and a bioresorbable membrane. Am J Orthod Dentofacial Orthop 2013; 143:724-34. [PMID: 23631974 DOI: 10.1016/j.ajodo.2012.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 11/22/2022]
Abstract
The permanent canine is the most frequently displaced or impacted tooth. The standard treatment for an impacted canine includes surgical exposure and orthodontic alignment. Autotransplantation is a treatment alternative for canines with complete root formation. The purpose of this article is to report a canine autotransplantation where the extraction site was preserved with a titanium prosthesis and a bioresorbable membrane. The autotransplanted canine had minimal root resorption and no ankylosis.
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Kumar R, Khambete N, Priya E. Successful immediate autotransplantation of tooth with incomplete root formation: case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e16-21. [DOI: 10.1016/j.oooo.2011.10.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 10/17/2011] [Indexed: 12/01/2022]
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Chugh A, Aggarwal R, Chugh VK, Wadhwa P, Kohli M. Autogenous tooth transplantation as a treatment option. Int J Clin Pediatr Dent 2012; 5:87-92. [PMID: 25206143 PMCID: PMC4093636 DOI: 10.5005/jp-journals-10005-1142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 02/03/2012] [Indexed: 11/23/2022] Open
Abstract
Autogenous tooth transplantation is the surgical movement of a tooth from one location in the mouth to another in the same individual. Though done for years but it has achieved variable success rates. Although the indications for autotransplantation are narrow, careful patient selection coupled with an appropriate technique can lead to exceptional esthetic and functional results. This article discusses the reviews of previous works done and highlights the criteria and factors influencing the success of autotransplant along with reports of two cases of transplantation of impacted and malposed canine. How to cite this article: Chugh A, Aggarwal R, Chugh VK, Wadhwa P, Kohli M. Autogenous Tooth Transplantation as a Treatment Option. Int J Clin Pediatr Dent 2012;5(1):87-92.
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Affiliation(s)
- Ankita Chugh
- Reader, Department of Oral and Maxillofacial Surgery, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India, e-mail:
| | - Rashmi Aggarwal
- Reader, Department of Oral and Maxillofacial Surgery, Chandra Dental College, Barabanki, Uttar Pradesh, India
| | - Vinay Kumar Chugh
- Assistant Professor, Department of Orthodontics, Faculty of Dental Sciences, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Puneet Wadhwa
- DMD Student, School of Dental Medicine, Boston University, MA USA
| | - Munish Kohli
- Professor and Head, Department of Oral and Maxillofacial Surgery, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Chawla S, Goyal M, Marya K, Jhamb A, Bhatia HP. Impacted Canines: Our Clinical Experience. Int J Clin Pediatr Dent 2011; 4:207-12. [PMID: 27678228 PMCID: PMC5034080 DOI: 10.5005/jp-journals-10005-1111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 05/19/2011] [Indexed: 11/23/2022] Open
Abstract
Background To discuss the management of impacted canines and the various approaches used for the same. Materials and methods The data of 33 cases, with 43 impacted canine teeth, seen and operated over a period of 3-year in Santosh Dental College and Hospital has been compiled. The diagnostic methods and treatment modalities undertaken are described and discussed. Results Canine impactions were more common in the maxilla as compared with mandible in our study, which was statistically significant. Impacted canine position was mostly palatal in maxilla and labial in mandible. Chi-square test yielded a p-value of 0.002 which shows that there is an association between arch and position. The treatment options used were surgical exposure and orthodontic repositioning, cyst enucleation with extraction of impacted canine and surgical removal of impacted canine. Conclusion Surgical exposure and orthodontic repositioning was successfully applied as first-line treatment for correcting ectopic positioned canine. In cases where exposure and subsequent orthodontic treatment was not indicated, the impacted canine was surgically removed to prevent future problems and surgical procedure was designed according to position of impacted canine.
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Affiliation(s)
- Sonia Chawla
- Reader, Department of Oral and Maxillofacial Surgery, Santosh Dental and Medical College Hospitals Ghaziabad, Uttar Pradesh, India
| | - Manoj Goyal
- Professor and Head, Department of Oral and Maxillofacial Surgery, Santosh Dental and Medical College Hospitals Ghaziabad, Uttar Pradesh, India
| | - Karan Marya
- Professor, Department of Oral and Maxillofacial Surgery, Santosh Dental and Medical College Hospitals Ghaziabad, Uttar Pradesh, India
| | - Aakarsh Jhamb
- Reader, Department of Oral and Maxillofacial Surgery, Santosh Dental and Medical College Hospitals Ghaziabad, Uttar Pradesh, India
| | - Hind Pal Bhatia
- Professor, Department of Pedodontic and Preventive Dentistry, Santosh Dental and Medical College Hospitals Ghaziabad, Uttar Pradesh, India
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Patel S, Fanshawe T, Bister D, Cobourne MT. Survival and success of maxillary canine autotransplantation: a retrospective investigation. Eur J Orthod 2010; 33:298-304. [DOI: 10.1093/ejo/cjq071] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jafarzadeh H, Abbott PV. Review of pulp sensibility tests. Part I: general information and thermal tests. Int Endod J 2010; 43:738-62. [DOI: 10.1111/j.1365-2591.2010.01754.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aslan BI, Üçüncü N, Doğan A. Long-Term Follow-up of a Patient with Multiple Congenitally Missing Teeth Treated with Autotransplantation and Orthodontics. Angle Orthod 2010; 80:396-404. [DOI: 10.2319/033109-184.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Belma Isik Aslan
- Research Assistant, Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Neslihan Üçüncü
- Professor, Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Altan Doğan
- Professor, Department of Periodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Teixeira CS, Pasternak B, Vansan LP, Sousa-Neto MD. Autogenous transplantation of teeth with complete root formation: two case reports. Int Endod J 2006; 39:977-85. [PMID: 17107543 DOI: 10.1111/j.1365-2591.2006.01170.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Autotransplantation is an alternative treatment for replacing lost teeth when suitable donor teeth are available. This paper presents two cases of successful autogenous tooth transplantation. SUMMARY Two third molars with complete root development were autogenously transplanted from their original sockets into new recipient sites on the same side of the mouth, one in the maxilla and one in the mandible. In both cases, the third molars were transplanted immediately after the first molar extractions. To provide better adaptation of the donor teeth, the recipient alveolar sites were remodelled using surgical burs. Semi-rigid splints were maintained for 45 and 15 days, respectively. Root canal treatment commenced one a week after transplantation and the canals were medicated with a calcium hydroxide paste before they were filled. Clinical and radiographic findings after 5 and 3 years of follow-up, respectively, are discussed in relation to the literature. KEY LEARNING POINTS Autogenous transplantation of teeth with complete root formation may be considered as a viable treatment option to conventional prosthetic and implant rehabilitation for both therapeutic and economic reasons. Careful surgical and endodontic procedure, together with careful case selection may lead to satisfactory aesthetic and functional outcomes.
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Affiliation(s)
- C S Teixeira
- School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
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Bauss O, Schilke R, Fenske C, Engelke W, Kiliaridis S. Autotransplantation of immature third molars: influence of different splinting methods and fixation periods. Dent Traumatol 2002; 18:322-8. [PMID: 12656866 DOI: 10.1034/j.1600-9657.2002.00147.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Different data were published documenting the influence of fixation methods and periods on the outcome of autotransplantations of teeth. Besides studies reporting increased ankylosis and disturbances of pulpal revascularization following rigid or extended fixation, there are studies revealing no connection in this matter. The clinical and radiological results of 76 transplanted germs of third molars were to be assessed after a rigid fixation for 4 weeks or after a suture splinting for 7 days and compared with each other. The choice of fixation method depended on the initial stability of the transplant. After a mean observation period of 3.4 years (range 1.0-6.1 years), 92.9% of the teeth stabilized with a suture, but only 73.5% fixed with an acid-etch composite and wire splint could be classified as successful (P = 0.029). The significant increases in ankylosis (P = 0.036) and pulp necrosis (P = 0.041) were the factors for the less favorable results of the rigidly fixed teeth. Our data support the results of other experimental and clinical studies with regard to the negative influences of an extended and rigid fixation on the success of tooth transplantation. However, apart from a correlation with the method and period of fixation, we also suspect the influence of an incongruity between the transplant and recipient site.
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Affiliation(s)
- Oskar Bauss
- Department of Orthodontics and Pedodontics, University Dental School, Geneva, Switzerland.
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Waikakul A, Kasetsuwan J, Punwutikorn J. Response of autotransplanted teeth to electric pulp testing. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:249-55. [PMID: 12221395 DOI: 10.1067/moe.2002.126162] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this retrospective study was to assess the results of third molar autotransplantation by using electric pulp testing (EPT) and to determine the correlation of EPT response and bone formation. STUDY DESIGN Fourteen patients with 22 transplanted teeth were studied. The patients had received autotransplantation of third molars and regularly came for follow-up on the third, sixth, ninth, and twelfth months. Postoperative clinical assessment included pain, inflammation of surrounding soft tissues, tooth mobility, and the EPT response. Periapical radiographs were subsequently evaluated during follow-up. The correlation between pulpal response to EPT and bone healing was analyzed. RESULTS Most of the teeth had normal mobility within 3 months, which corresponded to bone formation. Bone healing at the recipient sites completely occurred within 6 months, and more than 50% had lamina dura. The teeth with EPT response increased to 95% within 12 months. There was no significant association between the EPT response and bone formation. CONCLUSIONS The EPT response subsequently increased with time, and it seemed to be unchanged after 1 year.
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Affiliation(s)
- Aurasa Waikakul
- Department of Surgery, Mahidol University, Bangkok, Thailand
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Abstract
BACKGROUND A compilation of treatment options for impacted teeth is presented to assist dentists in discussing the sequelae of impacted teeth as well as the complications of treatment with their patients. OVERVIEW A differential diagnosis for an impacted tooth is not possible without clinical assessment. However, an ankylosed tooth or a tooth with failure of its eruption mechanism may be mistaken for an impacted tooth. This review of national and international dental texts, journals and publications concerning impacted teeth spans more than 50 years. PRACTICE IMPLICATIONS Treatment options for the management of impacted teeth are separated into four categories: observation, intervention, relocation and extraction. The indications, contraindications and complications of each option are presented. This information will help the clinician identify developmental conditions associated with an increased probability of tooth impaction and assess available treatment options.
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Affiliation(s)
- C A Frank
- University of Florida, Jacksonville, USA
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35
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Thomas S, Turner SR, Sandy JR. Autotransplantation of teeth: is there a role? BRITISH JOURNAL OF ORTHODONTICS 1998; 25:275-82. [PMID: 9884778 DOI: 10.1093/ortho/25.4.275] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Autotransplantation of teeth, if carried out successfully, ensures that alveolar bone volume is maintained due to physiological stimulation of the periodontal ligament. Autotransplantation has been carried out for many years, but with varying success rates. As a result, it is seldom regarded as an appropriate treatment option for patients with missing teeth especially with the continued development of osseo-integrated implants. Since placement of osseo-integrated implants in growing alveolar bone is contra-indicated, transplantation of available teeth remains a suitable choice for replacing missing units in the young patient. The role of autotransplantation of teeth in several clinical situations, the clinical techniques involved and factors influencing success of the transplant are discussed. The aim of this paper is to underline the evidence based principles for successful autotransplantation and present the technique as a viable treatment option in present day orthodontic practice.
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Affiliation(s)
- S Thomas
- Queen Alexandra Hospital, Portsmouth, UK
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Cohen AS, Shen TC, Pogrel MA. Transplanting teeth successfully: autografts and allografts that work. J Am Dent Assoc 1995; 126:481-5; quiz 500. [PMID: 7722109 DOI: 10.14219/jada.archive.1995.0211] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article suggests tooth transplantation as an alternative to other restorative options. The 10-year success rates for autografts--teeth moved from one location to another in a patient's mouth--range from 60 percent to 95 percent. Allografts, teeth moved from one person to another, are less successful. The authors report on one case of each type of transplant.
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Affiliation(s)
- A S Cohen
- University of Illinois at Chicago, School of Dentistry 60612, USA
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Gonda F, Nagase M, Chen RB, Yakata H, Nakajima T. Replantation: an analysis of 29 teeth. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1990; 70:650-5. [PMID: 2234886 DOI: 10.1016/0030-4220(90)90417-q] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The results of replantation of 29 teeth are described. Maxillary incisors constituted 85% of 27 permanent teeth. The period between avulsion and replantation ranged from within an hour to 86 days, but the actual extraoral period was within 5 hours in all but one case. Nineteen of the 27 permanent teeth were functioning for 7 months to 6 years and 7 months postoperatively. Root resorption was the cause of tooth loss in five cases. The incidence of root resorption seemed to increase with the increase of the extraoral period, but it was not affected by the period between avulsion and replantation, the condition of supporting tissues, the degree of root formation, and the type and period of splinting, indicating multiple factors involved in determining the prognosis of replanted teeth. In conclusion, every effort should be made to preserve avulsed teeth even in unfavorable conditions.
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Affiliation(s)
- F Gonda
- First Department of Oral and Maxillofacial Surgery, School of Dentistry, Niigata University, Japan
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Abstract
The results of the endodontic management of root resorption in 77 transplanted teeth are described. Apical bony radiolucency healed in 75 per cent of cases but the prognosis for root resorption was poorer; in only 34 per cent of cases was the resorption arrested. Various factors which might have influenced the outcome of treatment are discussed.
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