Effect of additional surgical procedures on root development of transplanted immature third molars

Combined application of artificial bone powders and concentrated growth factor membranes on the autotransplantation of mature third molars: A 5-year retrospective case series

AIM

This study aimed to observe the efficacy and outcomes of the combined application of artificial bone powder and concentrated growth factor (CGF) membranes for tooth transplantation in cases with wide recipient sockets and small donor teeth.

MATERIAL AND METHODS

A total of 36 teeth from 36 patients with wide recipient sockets and small donor teeth were enrolled. Autogenous tooth transplantation was performed using bone powders and CGF membranes. After transplantation, the visual analog scale (VAS) score, Landry Wound Healing Index, probing depth (PD), mobility, and gray value of the alveolar bone around the transplanted teeth were measured, and a patient satisfaction questionnaire was administered. All patients underwent clinical and radiographic examinations during follow-up.

RESULTS

The VAS score of 16 (44.4%) cases after 1 week was 0, and 26 (72.2%) patients showed excellent gingival healing after 2-4 weeks. The PD of a few cases was deeper than 3 mm during the first month; however, returned to normal after 3 months. Although the majority of the transplanted teeth possessed mobility greater than grade I during the first month, the mobility gradually improved within 3 months. The gray value of the alveolar bone around the transplanted teeth, 1 year postoperatively showed no difference with pre-operation (p > .05). During the mean follow-up period of 42.7 months (range 20-72 months), 33 of the 36 transplanted teeth remained in situ without clinical or radiographic complications, with an overall success rate of 91.7%.

CONCLUSIONS

Although the PD and mobility of the transplanted teeth were not ideal during the early stages of healing, most of the transplanted teeth had good clinical outcomes. In cases with large recipient sites accompanied by small donor teeth, autotransplantation of teeth using artificial bone powder combined with CGF membranes is a viable option and can lead to optimistic results with favorable success rates.

Retrospective Evaluation of Immediate Impacted Third Molars Autotransplantation After Extractions of Mandibular First and/or Second Molars With Chronic Periapical Lesions

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.

Autotransplantation of third molars with completely formed roots into surgically created sockets and fresh extraction sockets: a 10-year comparative study

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.

Autotransplantation of teeth in 215 patients. A follow-up study

OBJECTIVE

To evaluate the success rate of autotransplantation of teeth in consecutive patients and to analyze factors affecting the outcome.

MATERIALS AND METHODS

The subjects consisted of 215 consecutive patients (101 women and 114 men; aged 9.1-56.4 years, median age 15.2 years [P(10) = 11.4, P(90) = 19.7]) who had undergone transplantation of a total of 269 teeth, all by the same surgeon. In patients with multiple transplants, only the first transplant was included, to ensure that all transplanted teeth were independent units. The transplants were recorded as unsuccessful if the tooth had been extracted or was surviving but with root resorption or ankylosis. The interval between transplantation and final follow-up was a median 4.8 years (P(10) = 2.0, P(90) = 5.5) for successful transplants and a median of 2.4 years (P(10) = 0.4, P(90) = 7.7) for unsuccessful transplants.

RESULTS

One-hundred seventy-five (81%) of the transplantations were recorded as successful and 40 (19%) as unsuccessful. Twenty-five teeth had been extracted and 15 had survived but did not fulfill the criteria for success.

CONCLUSIONS

The success rate of 215 consecutively transplanted teeth was 81%. The highest success rate was for transplantation of premolars to the maxillary incisor region (100%). Complications at surgery such as difficult extraction, deviant root anatomy, or damaged root periodontium affected the outcome. During growth, a successful transplant preserves alveolar bone.