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Pedrinaci I, Calatrava J, Couso-Queiruga E, Bethencourt JDR, Sanz-Sanchez I, Gallucci GO, Sanz M. Tooth autotransplantation with adjunctive application of enamel matrix derivatives using a digital workflow: A prospective case series. J Dent 2024; 148:105131. [PMID: 38950765 DOI: 10.1016/j.jdent.2024.105131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES Digital protocols and bioactive materials may reduce complications and improve tooth autotransplantation (ATT) success and survival rates. This prospective study assesses the performance of a fully digital autotransplantation protocol of close-apex molars with the adjunctive application of Enamel Matrix Derivatives (EMD). METHODS Twelve adult patients with 13 hopeless molar teeth were replaced with autotransplantation of closed apex third molars. Outcomes, including success and survival rates, clinical, endodontic, radiographic, patient-reported outcome measures (PROMs), and digital image assessments, were conducted over a two-year follow-up period. RESULTS Survival and success rates were 100% and 91.2%, respectively, with no progressive inflammatory or replacement root resorption (ankylosis) except for one tooth presenting radiographic furcation involvement. A significant probing depth reduction of 2.4 ± 2.58 mm and CAL gains of 2.8 ± 3.03 mm were observed in transplanted teeth compared to the hopeless receptor teeth. Radiographic bone levels remained stable throughout the study period (-0.37 ± 0.66 mm), and digital image assessments showed minimal alveolar ridge width changes (-0.32 to -0.7 mm) and gingival margin changes (-0.95 to -1.27 mm) from baseline to last visit. PROMs indicated very high patient satisfaction. CONCLUSION The use of a digital ATT protocol with adjunctive use of EMD in closed-apex third molars demonstrated promising short-term high success and survival rates. Additionally, this type of therapy adequately preserves the dimensions of the alveolar ridge in the receptor site. CLINICAL SIGNIFICANCE This is the first prospective clinical study examining the effect of a digital tooth autotransplantation protocol combined with the application of EMD. It demonstrates that this approach is an effective treatment for replacing hopeless teeth and also validates the digital assessment of ATT alveolar ridge preservation at the recipient site.
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Affiliation(s)
- Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA; Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain.
| | - Javier Calatrava
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain
| | - Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Ignacio Sanz-Sanchez
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain; ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Mariano Sanz
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain; ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Restrepo-Restrepo FA, Uribe-Jaramillo DF, Villa-Machado PA, Mejía-Cardona JL, Abella-Sans F, Morales-Quezada RK, Tobón-Arroyave SI. Retrospective Follow-up Assessment of Risk Variables Influencing the Outcome of Autologous Tooth Transplantation. J Endod 2024; 50:747-757. [PMID: 38442852 DOI: 10.1016/j.joen.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION This retrospective study aimed to identify which patient-, donor tooth-, recipient site-, and surgical procedure-related variables may influence the outcome of tooth autotransplantation. METHODS The sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models. RESULTS After a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05). CONCLUSION Based on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient's bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.
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Affiliation(s)
| | - Diego F Uribe-Jaramillo
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Paula A Villa-Machado
- Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - José L Mejía-Cardona
- Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Francesc Abella-Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Reyna K Morales-Quezada
- Graduate Endodontics Program, Multidisciplinary Institute of Dental Specialties, Zapopan, México
| | - Sergio I Tobón-Arroyave
- Graduate Oral and Maxillofacial Surgery Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
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Chen Y, Zhou M, Liu J, Chi J, Yang X, Du Q, Ren X, Tian K. Multiple effects of dose-related GM-CSF on periodontal resorption in deep-frozen grafted teeth: A reverse study. Int Immunopharmacol 2024; 130:111745. [PMID: 38430803 DOI: 10.1016/j.intimp.2024.111745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Autologous tooth grafting is a dental restorative modality based on periodontal ligament healing.Human periodontal ligament stem cells(PDLSCs) are involved in the formation and remodeling of periodontal tissue.Based on previous findings, the proliferation and differentiation of processing cryopreserved periodontal ligament stem cells (PDLSCs) exhibit similarities to those of fresh cells. However, there is evident absorption in the transplanted frozen tooth's roots and bones, with the underlying cause remaining unknown. Granulocyte macrophage colony-stimulating factor(GM-CSF) is named for its produce granulocyte and macrophage precursors from bone marrow precursors, and it also serves as one of the regulatory factors in inflammatory and osteoclast formation. This study aimed to investigate changes in GM-CSF expression in frozen PDLSCs (fhPDLSCs) and evaluate the impact of GM-CSF on PDLSCs with respect to cellular activity and osteogenic ability. The role of GM-CSF in periodontal absorption was further speculated by comparing with IL-1β. The results revealed a significant increase in GM-CSF levels from fhPDLSCs compared to fresh cells, which exhibited an equivalent inflammatory stimulation effect as 1 ng/ml IL-1β. Cell viability also increased with increasing concentrations of GM-CSF; however, the GM-CSF from fhPDLSCs was not sufficient to significantly trigger osteoclastic factors. Considering its interaction with IL-1β and positive feedback mechanism, environments with high doses of GM-CSF derived from fhPDLSCs are more likely to activate osteoclastic responses.Therefore, for frozen tooth replantation, great attention should be paid to anti-inflammation and anti-infection.GM-CSF may serve as a potential therapeutic target for inhibiting periodontal resorption in delayed grafts.
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Affiliation(s)
- Yue Chen
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Min Zhou
- Department of Stomatology, Chengfei Hospital, Chengdu 610091, China
| | - Juanxiu Liu
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Junzhou Chi
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Xin Yang
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Qin Du
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Xiaohua Ren
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
| | - Kun Tian
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China.
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Liu Z, Zhou NG, Li Y, Zhou L. Autotransplantation for Restoration of Dentition Defects After Excision of Jaw Cysts. J Craniofac Surg 2024; 35:e58-e60. [PMID: 37955447 DOI: 10.1097/scs.0000000000009809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/26/2023] [Indexed: 11/14/2023] Open
Abstract
Bone defect caused by jaw cystectomy has always been the main factor affecting postoperative wound healing and is also the common cause of maxillofacial bone defect, which brings challenges to the subsequent restoration of missing teeth. In this paper, the authors report a 22-year-old young woman who had a mandibular cyst in the left lower posterior tooth area. She underwent mandibular bone cyst excision and simultaneous extraction of teeth 36 and 37. One and two months after the removal of the mandibular bone cyst, autologous tooth transplantation was performed in stages from tooth 28 to tooth 36 and from tooth 18 to tooth 37. The case shows that tooth autotransplantation is a viable option for the restoration of dentition defects after the excision of jaw cysts, which can promote the healing of the bone defect after the operation.
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Affiliation(s)
- Zhuying Liu
- Department of Stomatology, 32265 Army of Chinese People's Liberation Army
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Nian-Gou Zhou
- Department of Stomatology, 32265 Army of Chinese People's Liberation Army
| | - Yongqi Li
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Libin Zhou
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
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Liao F, Wang H, Zhao J, Zhang B, Zhong H. Effectiveness evaluation of autotransplanted teeth after performing extraoral endodontic surgery instead of conventional root canal therapy. BMC Oral Health 2023; 23:1005. [PMID: 38097962 PMCID: PMC10722803 DOI: 10.1186/s12903-023-03733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE The aim of this study was to examine the viability and efficacy of utilizing extraoral apicoectomy and retrograde filling in combination to seal the root canal system of mature molars without the need for root canal therapy (RCT) during the autotransplantation of teeth (ATT). MATERIALS AND METHODS This study screened 27 patients who received ATT at the Department of Oral Surgery in the Hospital of Stomatology from 2019 to 2021. Extraoral apicoectomy and retrograde filling were performed, while RCT was temporarily not performed. The study analysed the periodontal status and masticatory function of transplanted teeth one to three years postoperation and used cone-beam computed tomography (CBCT) and periapical radiograph (PA) to evaluate the integrity of the periodontal space and intra/periapical inflammation. The potential predictors of survival/success were analysed statistically. We also conducted questionnaires and chewing efficiency tests. RESULTS In this study, 27 TTs from 27 patients were found to be fully functional in terms of chewing ability. The overall survival rate was 100% (27/27), and the success rate was 70.4% (19/27). A total of 90.9% (20/22) of patients reported being satisfied or very satisfied with their TTs. Additionally, the chewing efficiency of the transplantation side was on average 82.0% of that of the healthy side, with a significant difference between the two sides (P < 0.05). None of the potential predictors were found to significantly affect the success or survival of the transplanted tooth (TT). CONCLUSION The combination of extraoral apicoectomy and retrograde filling in TT showed promising outcomes, but further clinical cases and longer follow-up times are still required to validate the treatment plan.
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Affiliation(s)
- Fenglin Liao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hui Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jihong Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Biao Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Endodontics,School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Haoyan Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Nie Q, Li C, Yang J, Yao Y, Sun H, Jiang T, Grzegorzek M, Chen A, Chen H, Hu W, Li R, Zhang J, Wang D. OII-DS: A benchmark Oral Implant Image Dataset for object detection and image classification evaluation. Comput Biol Med 2023; 167:107620. [PMID: 37922604 DOI: 10.1016/j.compbiomed.2023.107620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
In recent years, there is been a growing reliance on image analysis methods to bolster dentistry practices, such as image classification, segmentation and object detection. However, the availability of related benchmark datasets remains limited. Hence, we spent six years to prepare and test a bench Oral Implant Image Dataset (OII-DS) to support the work in this research domain. OII-DS is a benchmark oral image dataset consisting of 3834 oral CT imaging images and 15240 oral implant images. It serves the purpose of object detection and image classification. To demonstrate the validity of the OII-DS, for each function, the most representative algorithms and metrics are selected for testing and evaluation. For object detection, five object detection algorithms are adopted to test and four evaluation criteria are used to assess the detection of each of the five objects. Additionally, mean average precision serves as the evaluation metric for multi-objective detection. For image classification, 13 classifiers are used for testing and evaluating each of the five categories by meeting four evaluation criteria. Experimental results affirm the high quality of our data in OII-DS, rendering it suitable for evaluating object detection and image classification methods. Furthermore, OII-DS is openly available at the URL for non-commercial purpose: https://doi.org/10.6084/m9.figshare.22608790.
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Affiliation(s)
- Qianqing Nie
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, Liaoning, China
| | - Chen Li
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China; Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, Liaoning, China.
| | - Jinzhu Yang
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, Liaoning, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, USA
| | - Hongzan Sun
- Shengjing Hospital, China Medical University, Shenyang, China
| | - Tao Jiang
- School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China; International Joint Institute of Robotics and Intelligent Systems, Chengdu University of Information Technology, Chengdu, China
| | - Marcin Grzegorzek
- Institute of Medical Informatics, University of Luebeck, Luebeck, Germany; Department of Knowledge Engineering, University of Economics in Katowice, Katowice, Poland
| | - Ao Chen
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Haoyuan Chen
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Weiming Hu
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Rui Li
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Jiawei Zhang
- Microscopic Image and Medical Image Analysis Group, College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Danning Wang
- Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
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Sakhariya SV, Waknis PP, Barbhai S. Autogenous bone chip interspersed in PRF and PRP as an augmentative bio material in autogenous tooth transplant - A case report. Int J Surg Case Rep 2023; 112:108983. [PMID: 37883872 PMCID: PMC10667896 DOI: 10.1016/j.ijscr.2023.108983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Autotransplantation technique involves extraction of tooth from the recipient site and donor tooth without damage, placing and stabilizing donor tooth within same individual. The use of autogenous bone combined with platelet rich fibrin (PRF) and platelet rich plasma (PRP) seems to be favorable to achieve stable alveolar bone. Thus we provide an innovative adjuvant method for enhancing bone formation using PRF and inter-radicular bone with PRP as autogenous graft. PRESENTATION OF CASE A 26 year old healthy female individual reported university teaching hospital to outpatient department of oral and maxillofacial surgery, with complain of decayed tooth. On clinical and radiographic examination it was diagnosed was chronic irreversible pulpitis with to left maxillary first molar. Looking at clinical profile, age and health status an autogenous tooth transplant was advised. DISCUSSION Periodontal ligament, interradicular bone autografts, PRF and PRP has potential to induce formation of alveolar bone and is recommended in cases of atrophy of alveolar process. CONCLUSION The solution mentioned can be hypothesized to improve - quantity and quality of bone formed, reduce the chances of ankylosis of the tooth, bone loss, sinus perforation.
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Affiliation(s)
- Samkit V Sakhariya
- Dept. of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India.
| | - Pushkar P Waknis
- Dept. of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sourabh Barbhai
- Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Pattanshetti C, Sankeshwari B, Shinde S, Kadam P, Kadam H, Shirkande A. Clinical Assessment of Immediate Autotransplantation of Mandibular Third Molars: An In Vivo Study. Cureus 2023; 15:e41293. [PMID: 37539402 PMCID: PMC10394477 DOI: 10.7759/cureus.41293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients' teeth with developing alveolar bone because it uses the patient's own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar. MATERIALS AND METHODS In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed. RESULTS Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption. CONCLUSION Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.
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Affiliation(s)
| | | | - Santaji Shinde
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Sangli, IND
| | - Poornima Kadam
- Pathology, Bharati Vidyapeeth Medical College and Hospital, Sangli, IND
| | - Harshawardhan Kadam
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Sangli, IND
| | - Amol Shirkande
- Orthodontics and Dentofacial Orthopaedics, Bharati Vidyapeeth Dental College and Hospital, Sangli, IND
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Soliman AH, Sharara H, El Hadidi YN, Saber SM. Autotransplantation of an Impacted Premolar Associated with a Unicystic Ameloblastoma: A Long-Term Follow-up Report of a Clinical Case (A Case Report and a Technical Note). J Maxillofac Oral Surg 2023; 22:502-504. [PMID: 37122801 PMCID: PMC10130279 DOI: 10.1007/s12663-022-01777-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/10/2022] [Indexed: 10/15/2022] Open
Affiliation(s)
| | - Hesham Sharara
- Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Yasser Nabil El Hadidi
- Department of Oral and maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Gómez Meda R, Abella Sans F, Esquivel J, Zufía J. Autotransplantation of Maxillary Third Molar with Its Attached Buccal Cortical Plate Combined with a Connective Tissue Graft. J Endod 2023; 49:313-320. [PMID: 36623751 DOI: 10.1016/j.joen.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Tooth replacement often leads to insufficient vertical volume in the recipient socket bone. The aim of this novel report is to present a successful fully guided autotransplantation of a maxillary right third molar (tooth #1) with its attached buccal plate. The procedure was combined with a palatal connective tissue graft to reconstruct a buccal hard and soft tissue defect of an irreparable maxillary right first molar (tooth #3). METHODS A 45-year-old man complaining of pain in tooth #3 came to the clinic. Tooth #3 was non-restorable due to an extensive caries and a vertical root fracture of the mesiobuccal root, leading to a total loss of the buccal cortical plate. Guided autotransplantation of tooth #1 was completed by using 3-dimensional surgical templates for implant burs and a 3-dimensional-printed replica. After positioning the donor tooth, the cortical plate was fixed to the recipient socket with osteosynthesis screws. A connective tissue graft was also harvested to increase the band of keratinized gingiva and the thickness of the buccal soft tissue. At 6-month follow-up, the screws were removed, showing excellent regeneration throughout the buccal area. RESULTS At 3-year follow-up, the transplanted tooth was asymptomatic, with a natural bone level and no signs of replacement or inflammatory root resorption. CONCLUSIONS The use of a donor tooth and its attached bone cortical plate combined simultaneously with a connective tissue graft appears to improve hard and soft tissues in a single procedure.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
| | - Jonathan Esquivel
- Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Albalooshy A, Duggal M, Vinall-Collier K, Drummond B, Day P. The outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries. Dent Traumatol 2023. [PMID: 36740836 DOI: 10.1111/edt.12829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Tooth auto-transplantation is a treatment option, which is often not considered to replace anterior maxillary incisors in children and adolescents. There are multiple prognostic factors that may influence the outcomes of premolar auto-transplantation, but there is limited evidence from human studies. The aim of this study was to report the outcomes of auto-transplanted premolars in the anterior maxilla following traumatic dental injuries (TDIs) and to identify their prognostic factors. MATERIALS AND METHODS The clinical records of patients who had premolars transplanted in the anterior maxilla following TDI, with appropriate radiographs and a minimal of 1-year follow-up, were reviewed retrospectively. A specific data extraction form was developed, tested and used to collect information for the prognostic factors and outcomes. RESULTS The cohort included 120 patients with 144 auto-transplanted premolars. The mean age was 12.2 years (±2.0), and the mean observation period was 3.7 years (±1.8). The success rate was 80%, and the survival rate was 93%. Unfavourable outcomes included external replacement resorption in 12.5%, uncontrolled external inflammatory resorption in 2.7%, and both resorption types in 4.9% of teeth. Periodontal healing was significantly associated with donor tooth root maturity, graft handling at the time of surgery including ease of donor tooth extraction and placement at the recipient sites, recipient site alveolar bone status, and post-operative transplant mobility. Seventy-four teeth (53.4%) were immature at the time of transplantation where pulp revascularisation was anticipated, and 52 (70%) of those had radiographic and clinical signs of pulp healing. Pulp healing was significantly related to donor tooth eruption stage, ease of extraction of donor tooth, and ease of placement in the recipient site. CONCLUSIONS Good outcomes were observed for premolar teeth auto-transplanted in the anterior maxilla. The main prognostic factors were ease of extraction of donor tooth and ease of placement in the recipient sites and donor tooth root maturity.
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Affiliation(s)
| | - Monty Duggal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Peter Day
- Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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Park JH, Kim YG, Suh JY, Jin MU, Lee JM. Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111517. [PMID: 36363473 PMCID: PMC9698643 DOI: 10.3390/medicina58111517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023]
Abstract
Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.
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Affiliation(s)
- Jin-Han Park
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Korea
| | - Yong-Gun Kim
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Korea
| | - Jo-Young Suh
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Korea
| | - Myoung-Uk Jin
- Department of Conservative Dentistry, Kyungpook National University School of Dentistry, Daegu 41940, Korea
- Correspondence: (M.-U.J.); (J.-M.L.); Tel.: +82-53-600-7623 (M.-U.J.); +82-53-600-7522 (J.-M.L.)
| | - Jae-Mok Lee
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu 41940, Korea
- Correspondence: (M.-U.J.); (J.-M.L.); Tel.: +82-53-600-7623 (M.-U.J.); +82-53-600-7522 (J.-M.L.)
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Algubeal HM, Alanazi AF, Arafat AS, Fatani B, Al-Omar A. Autotransplantation of the Lower Posterior Teeth: A Comprehensive Review. Cureus 2022; 14:e27875. [PMID: 36110461 PMCID: PMC9462596 DOI: 10.7759/cureus.27875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 12/25/2022] Open
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14
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Zhang H, Cai M, Liu Z, Liu H, Shen Y, Huang X. Combined Application of Virtual Simulation Technology and 3-Dimensional-Printed Computer-Aided Rapid Prototyping in Autotransplantation of a Mature Third Molar. Medicina (B Aires) 2022; 58:medicina58070953. [PMID: 35888672 PMCID: PMC9323372 DOI: 10.3390/medicina58070953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
The use of computer-aided rapid prototyping (CARP) models was considered to reduce surgical trauma and improve outcomes when autotransplantation of teeth (ATT) became a viable alternative for dental rehabilitation. However, ATT is considered technique-sensitive due to its series of complicated surgical procedures and unfavorable outcomes in complex cases. This study reported a novel autotransplantation technique of a 28-year-old patient with an unrestorable lower first molar (#36) with double roots. Regardless of a large shape deviation, a lower third molar (#38) with a completely single root formation was used as the donor tooth. ATT was performed with a combined use of virtual simulation, CARP model-based rehearsed surgery, and tooth replica-guided surgery. A 3D virtual model of the donor and recipient site was generated from cone-beam computed tomographic (CBCT) radiographs prior to surgery for direct virtual superimposition simulation and CARP model fabrication. The virtual simulation indicated that it was necessary to retain cervical alveolar bone during the surgical socket preparation, and an intensive surgical rehearsal was performed on the CARP models. The donor tooth replica was used during the procedure to guide precise socket preparation and avoid periodontal ligament injury. Without an additional fitting trial and extra-alveolar storage, the donor tooth settled naturally into the recipient socket within 30 s. The transplanted tooth showed excellent stability and received routine root canal treatment three weeks post-surgery, and the one-year follow-up examination verified the PDL healing outcome and normal functioning. Patient was satisfied with the transplanted tooth. This cutting-edge technology combines virtual simulation, digital surgery planning, and guided surgery implementation to ensure predictable and minimally invasive therapy in complex cases.
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Affiliation(s)
- Hui Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; (H.Z.); (M.C.); (Z.L.)
| | - Min Cai
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; (H.Z.); (M.C.); (Z.L.)
| | - Zhiguo Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; (H.Z.); (M.C.); (Z.L.)
| | - He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
- Correspondence: (Y.S.); (X.H.)
| | - Xiangya Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; (H.Z.); (M.C.); (Z.L.)
- Correspondence: (Y.S.); (X.H.)
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Bai Y, Cui J, Sun H, Zhou Z, Shi L, Li P, Liu J. The enhanced conservation of vital pulp and apical tissues by the application of crown rotation surgery for inversely impacted central incisors: a follow-up analysis of two patients over four years. Int Endod J 2022; 55:882-888. [PMID: 35543607 DOI: 10.1111/iej.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022]
Abstract
AIM To describe a novel surgical method (crown rotation surgery) to manage inversely impacted central incisors with immature roots. SUMMARY Two young patients each presented with an inversely impacted maxillary central incisor. To protect the apical tissues, the two impacted incisors were rotated downwards to a relatively normal position without extraction from their bony sockets. After crown rotation surgery, spontaneous eruption, continuous root development, and periodontal healing of the rotated incisors were observed. The pulp retained vitality and blood flow was normal. Moreover, there were no obvious signs of pulp canal obliteration (PCO), as indicated by Cone Beam Computed Tomography (CBCT) imaging. KEY LEARNING POINTS • By optimising protection of the vital pulp and apical tissues, crown rotation surgery represents a minimally invasive, conservative, and practical surgical technique for treating inversely impacted incisors with developing roots. • In contrast to existing surgical methods, crown rotation surgery may avoid certain complications, including PCO and abnormal or arrested root development.
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Affiliation(s)
- Yudi Bai
- Department of Stomatology, Air Force Medical Center, Fourth Military Medical University (FMMU), Beijing, 100142, China
| | - Jiantong Cui
- First Clinical Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Hua Sun
- Lintong Sanatorium Center of PLA, Xi'an, 710600, China
| | - Zhifei Zhou
- Department of Stomatology, General Hospital of Tibetan Military Command, Lhasa, Tibet, 850000, China
| | - Liqiang Shi
- Department of Radiology, School of Stomatology, FMMU, Xi'an, 710032, China
| | - Pan Li
- Zibo Stomatological Hospital, Zibo City, Shandong Province 255000, China
| | - Jin Liu
- Department of Operative Dentistry and Endodontics, School of Stomatology, FMMU, Xi'an, 710032, China.,Huangshan City People's Hospital, Anhui Province, China
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Han S, Wang H, Chen J, Zhao J, Zhong H. Application effect of computer-aided design combined with three-dimensional printing technology in autologous tooth transplantation: a retrospective cohort study. BMC Oral Health 2022; 22:5. [PMID: 35012525 PMCID: PMC8751250 DOI: 10.1186/s12903-021-02030-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The activity of donor periodontal membrane is the key factor of autologous tooth healing. The application of digital aided design, 3D printing model and guide plate in autotransplantation of tooth (ATT) is expected to reduce the damage of periodontal membrane and preserve the activity of periodontal membrane, so as to improve the success rate of ATT. This study tried to prove the role of digital technology in improving the success rate of ATT, although there are differences in model accuracy in practice. METHODS We included 41 tooth autotransplantation cases which assisted by 3D-printed donor models and surgical guides and divided them into two groups in accordance with whether the donor tooth could be placed successfully after the preparation of alveolar socket guided by the model tooth. Then, we compared and analyzed the preparation time of alveolar socket, extra-alveolar time, and number of positioning trials of the donor tooth between the two groups. We also included a comparison of the in vitro time of the donor tooth with that of 15 min. The incidence of complications was included in the prognostic evaluation. RESULTS The mean preparation time of the alveolar socket, mean extra-alveolar time of donor tooth, and mean number of positioning trials with donor tooth of 41 cases were 12.73 ± 6.18 min, 5.56 ± 3.11 min, and 2.61 ± 1.00, respectively. The group wherein the donor tooth cannot be placed successfully (15.57 ± 6.14 min, 7.29 ± 2.57 min) spent more preparation time of alveolar socket and extra-alveolar time than the group wherein the donor tooth can be placed successfully (9.75 ± 4.73 min, 3.75 ± 2.57 min). The number of positioning trials with the donor tooth of the group wherein the donor tooth cannot be placed successfully (3.19 ± 0.75) was higher than that of the other group (2.00 ± 0.86). There was no significant difference in survival rates between the two groups. CONCLUSIONS Compared with the traditional tooth autotransplantation, the introduction of computer-aided design combined with 3D printing of the model tooth and surgical guides evidently shortens the preparation time of the alveolar socket and the extra-alveolar time of the donor tooth and reduces the number of positioning trials with the donor tooth regardless of the shape deviation between the model and actual teeth.
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Affiliation(s)
- Shuang Han
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, China
| | - Hui Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, China
| | - Jue Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, China
| | - Jihong Zhao
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haoyan Zhong
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, China.
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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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de Freitas Coutinho NB, Nunes FC, Gagno Intra JB, Roldi A, de-Jesus-Soares A, Coelho MS, Frozoni M. Success, Survival Rate, and Soft Tissue Esthetic of Tooth Autotransplantation. J Endod 2020; 47:391-396. [PMID: 33245974 DOI: 10.1016/j.joen.2020.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/23/2020] [Accepted: 11/11/2020] [Indexed: 11/29/2022]
Abstract
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 ensure 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 a 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 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 males and 12 females) had 43 anterior teeth replaced, including 42 central incisors and 1 lateral incisor. The follow-up period ranged from 1-25 years. In regard to success and the 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.
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Affiliation(s)
| | | | | | - Armelindo Roldi
- Brazilian Association of Dentistry, Vitória, Espírito Santo, Brazil
| | | | | | - Marcos Frozoni
- São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
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Guided Osteotomy and Guided Autotransplantation for Treatment of Severely Impacted Teeth: A Proof-of-Concept Report. J Endod 2020; 46:1791-1798. [PMID: 32738340 DOI: 10.1016/j.joen.2020.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The aim was to present a novel surgical technique using virtually preplanned 3-dimensional (3D)-printed templates for guided osteotomies. These were to ensure atraumatic uncovering of a severely impacted donor tooth including guided drilling of the recipient alveolus followed by a secure autotransplantation procedure. METHODS This report presents an autotransplantation procedure of a 14-year-old patient with a severely impacted second premolar and extensive contact to the roots of the adjacent teeth and the inferior alveolar nerve. Autotransplantation of the impacted premolar was virtually performed using modified methods from guided implant surgery in order to prefabricate 3D-printed templates with the aid of a fully digital workflow. RESULTS Satisfactory treatment could be achieved using surgical templates for guided osteotomies of the surgical access, guided drilling of the recipient site, and occlusal reference template ensuring autotransplantation in the appropriate 3D location of the graft. An atraumatic approach could be ensured with an extraoral time of 46 seconds by 1 fitting attempt; no injuries or altered sensation of the inferior alveolar nerve were present. A vital natural tooth could be observed. CONCLUSIONS This innovative technique uses for the first time a fully implemented digital workflow for guided osteotomies, guided drilling, and guided autotransplantation of a severely impacted tooth. 3D-printed templates could ensure a guided atraumatic approach and facilitate highly complex treatments by virtually implementing recommended guidelines in future autotransplantations.
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