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Ainiwaer A, Gong Z, Zuolipahaer Z, Wang L. Midterm outcomes of autogenous mature third molars transplantation into surgically created sockets: A retrospective cohort study. Dent Traumatol 2024. [PMID: 38641921 DOI: 10.1111/edt.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/16/2024] [Accepted: 04/02/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND/AIMS The purpose of this study was to observe the outcome of mature third molars transplantation into surgically created sockets with the assistance of computer designed three dimensional (3-D) printed replicas and compare its outcome with the conventional fresh socket autotransplantation. MATERIAL AND METHODS This study included total of 96 mature third molars autotransplanted in 96 cases with the guidance of computer designed 3-D printed replicas. Forty-eight teeth autotransplanted into surgically created sockets were enrolled into the surgically created socket group and 48 teeth conventionally autotransplanted into fresh sockets were enrolled into the fresh socket group. In the surgically created socket group, mature third molars were autotransplanted into surgically prepared sockets at the site of previously missed or extracted molars in the alveolar bone and in the fresh socket group, autotransplantation of mature third molars were performed in fresh sockets of extracted diseased molars simultaneously. After transplantation, the visual analogue scale (VAS) score, Landry Wound Healing Index (LWHI), mobility and probing depth (PD) of the transplanted teeth were measured and the patient satisfaction questionnaire were held in both group. All patients underwent clinical and radiographic examinations during the follow-up. RESULTS During the mean follow-up period of 47.63 ± 16.78 months (range 18-78 months), 92 out of 96 teeth remained in situ without clinical or radiographic complications with overall success rate of 95.83%. No statistically significant differences were found in success and survival rates between the two group. The average extra-oral time of the donor teeth were 60.76 ± 22.41 s and mean positioning trials of the donor teeth were 2.43 ± 1.19. The VAS score at Day 1 in the surgically created socket group was higher than the fresh socket group (p < .05). LWHI scores in the surgically created group were lower than the fresh socket group during the first 2 weeks (p < .05). The degree of mobility of the transplanted teeth in both group showed no statistically significant difference during the first 3 months. PD in the surgically created group were higher than the fresh socket group in the first month but there were no statistically significant difference after 1 month. Twenty-six out of 48 cases in the surgically created group needed crown restoration while only 10 cases went through crown restoration in the fresh socket group. Most patients in both group were satisfied with the treatment. CONCLUSIONS Autogenous mature third molars transplantation into surgically created sockets is as effective as conventional fresh socket transplantation. This technique is worth recommending in carefully selected cases and optimistic results can be achieved.
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Affiliation(s)
- Ailimaierdan Ainiwaer
- Department of Oral Surgery Clinic, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital). Research Institute of Stomatology of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zhongcheng Gong
- Department of Maxillofacial Tumor Surgery, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital). Research Institute of Stomatology of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zulikamaier Zuolipahaer
- Nursing Department, Urumqi Eye Ear Throat Hospital (Urumqi International Hospital), Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Ling Wang
- Department of Oral Surgery Clinic, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital). Research Institute of Stomatology of Xinjiang Uygur Autonomous Region, Urumqi, China
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Putrino A, Marinelli E, Agrillo A, Zaami S. New Perspectives in Third Molar Auto-Transplantation: Literature Review and a Case Report of Clinical, Financial and Forensic Implications. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:473. [PMID: 38541199 PMCID: PMC10972373 DOI: 10.3390/medicina60030473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 07/23/2024]
Abstract
Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors.
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Affiliation(s)
- Alessandra Putrino
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Alessandro Agrillo
- Maxillofacial Surgery Unit, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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Abella F, Garcia-Font M, Nagendrababu V, Dummer PMH, Durán-Sindreu F, Rosales A, Olivieri JG. Accuracy of CAD-CAM surgically guided tooth autotransplantation using guided templates and custom-designed osteotomes in human cadaver mandibles. J Endod 2023:S0099-2399(23)00359-X. [PMID: 37348814 DOI: 10.1016/j.joen.2023.06.008] [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: 04/27/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION A major challenge in dentistry is the replacement of teeth lost prematurely due to trauma, caries, or malformations, especially in growing patients. The aim of this study was to assess the accuracy of CAD-CAM surgically guided tooth autotransplantation in cryopreserved cadaver mandibles using guided templates and custom-designed osteotomes. METHODS Cryopreserved human cadaver heads were digitized and scanned using an intraoral optical scanner and a large-volume cone beam computed tomography (CBCT) device. First, virtual surgical planning was performed to create a 3D tooth replica, two surgical guides, and a custom-made osteotome for each single-rooted tooth autotransplantation procedure/case. Surgical sockets were created in the selected mandibles using guided tooling consisting of an initial guided osteotomy with implant burs and a final guided osteotomy using custom osteotomes. After tooth autotransplantation, second large-volume CBCT images of the five cadaver mandibles were obtained. The discrepancy in mm within the 3D space (apical and mesiodistal deviations) between the final position of the autotransplanted teeth and their digitally planned 3D initial position was calculated and analyzed statistically (P< .05). RESULTS All donor teeth were placed without incident within their newly created sockets in the real mandibles. The mean difference between the digitally planned root apex position and the final tooth position was 2.46±1.25mm. The mesiodistal deviation of the autotransplanted teeth was 1.63±0.96mm. CONCLUSIONS The autotransplantation of single-rooted teeth with custom-designed and 3D-printed surgical tooling provided promising results. The technique was able to create surgically prepared sockets that could accommodate transplanted teeth in mandibles.
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Affiliation(s)
- Francesc Abella
- Department of Endodontics. Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - Marc Garcia-Font
- Department of Endodontics. Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain.
| | - Venkateshbabu Nagendrababu
- University of Sharjah, College of Dental Medicine, Department of Preventive and Restorative Dentistry, Sharjah, UAE
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Fernando Durán-Sindreu
- Department of Endodontics. Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - Andrea Rosales
- Department of Endodontics. Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - Juan Gonzalo Olivieri
- Department of Endodontics. Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
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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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Chen HH, Chen G, Su H. Orthodontic treatment of substituting third molars for missing permanent molars. Am J Orthod Dentofacial Orthop 2023; 163:173-180. [PMID: 36476369 DOI: 10.1016/j.ajodo.2021.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION This study aimed to evaluate the orthodontic effect and efficiency of substituting third molars for missing first or second permanent molars systematically. METHODS Forty-six patients (69 third molars total) with missing permanent molars replaced by third molars were selected. The angulation, crown-to-root ratio, and periodontal condition of the third molars before and after treatment were compared. The American Board of Orthodontics Objective Grading System was used to evaluate the alignment and occlusion of third molars after treatment. The duration of orthodontic treatment and third molar replacement therapy were also recorded. RESULTS The average orthodontic treatment time was 33.9 ± 5.6 months, and the average angulation change of third molars during treatment was 49.8 ± 29.8°. The average height of mesial alveolar bone increased by 4.8 ± 0.5 mm in patients whose third molars were mesially inclined or horizontally impacted. The root length of adult patients decreased by 0.72 ± 0.02 mm on average, and the average gingival recession was 0.10 mm, both of which were not statistically significant. The average score for each third molar evaluated by the American Board of Orthodontics Objective Grading System was 1.8 ± 0.5 points. CONCLUSIONS If the indications and timing of treatment were well-controlled, third molars would be excellent substitutes for missing first or second permanent molars through the orthodontic method.
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Affiliation(s)
- Huan-Huan Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gui Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Hong Su
- The First Clinical Division, Peking University School and Hospital of Stomatology, and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
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Does Root Development Status Affect the Outcome of Tooth Autotransplantation? A Systematic Review and Meta-Analysis. MATERIALS 2022; 15:ma15093379. [PMID: 35591712 PMCID: PMC9103755 DOI: 10.3390/ma15093379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 02/01/2023]
Abstract
Background: Tooth autotransplantation is defined as the surgical repositioning of an autogenous tooth in another surgical site within the same individual. Aim: The aim of this research was to analyze the outcome of tooth transplantation using immature donor teeth compared with closed apex teeth and to compare differences between donor tooth positions on the arch. Methods: Electronic and manual literature searches were performed in different databases, including the National Library of Medicine (MEDLINE), EMBASE (OVID), Cochrane Central (CENTRAL), and the digital library of the Universitat Internacional de Catalunya (UIC University) from 1978 to March 2021. Studies were selected when they fulfilled the following criteria: only human prospective clinical studies, minimum sample size of 10 patients, minimum follow-up of 1 year, studies reporting or with at least deducible data on survival rates, immediate tooth autotransplantation with completed or incomplete root formation, and publications in the English language. A meta-analysis of random effects was developed to estimate the global effect measure of the survival rate, success rate, and root resorption involving the total sample, as well as open- and closed-apex groups. Results: Twenty-four articles were eligible for analysis. The Cohen’s kappa corresponding to this review was 0.87, and the risk assessment was considered low–moderate for the included studies. Overall survival and success rates were 95.9% and 89.4%, respectively, with a mean follow-up of 4 years and an overall mean age of 25.2 ± 12.3 years. Closed apex teeth showed a survival rate of 3.9% lower than that of open apex teeth. Higher complication rates were found for both inflammatory external root resorption and replacement root resorption in the closed-apex group, without reaching statistical significance. Conclusions: Tooth autotransplantation is a viable treatment alternative, regardless of the apical condition, with high survival and success rates after a mean follow-up of 4 years. Open-apex donor teeth could be considered the gold-standard option, showing lower complication rates when compared to closed-apex donor teeth. Future randomized controlled clinical studies are needed to examine the long-term prognosis of this technique.
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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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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Abella Sans F, Ribas F, Doria G, Roig M, Durán-Sindreu F. Guided tooth autotransplantation in edentulous areas post-orthodontic treatment. J ESTHET RESTOR DENT 2021; 33:685-691. [PMID: 34002459 DOI: 10.1111/jerd.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Tooth autotransplantation with a complete root formation to replace one or more lost teeth is indicated as a cost-effective alternative to implants. The aim of this case report was to describe a successfully guided autotransplantation of a maxillary third molar with fully formed roots into a surgically created socket after orthodontic space opening. CLINICAL CONSIDERATIONS A guided autotransplantation of the maxillary left third molar into the missing maxillary left first molar site was chosen. After virtually orientating donor tooth to confirm its optimum fit, it was deemed necessary to open 4 mm the mesiodistal space. Following the orthodontic movement, a 3-dimensional (3D)-guiding template and a milled surgical guide were manufactured to allow the donor tooth to be transplanted exactly in the planned position. The 2-year follow-up periapical radiograph showed a continuous periodontal space with no signs of apical periodontitis or root resorption. CONCLUSIONS Virtual planning and 3D-printed tooth replica combined with guided surgery can simplify the autotransplantation technique for both the clinician and the patient, particularly when the socket has been completely created during surgery. CLINICAL SIGNIFICANCE Virtual digital planning, which can accurately calculate the exact space to open orthodontically before an autotransplantation, could prove essential to enhancing the precision of 3D placement of the donor tooth in the recipient site.
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Affiliation(s)
- Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ferran Ribas
- Department of Oral Surgery, Private practice, Barcelona, Spain
| | - Guillermo Doria
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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Lucas-Taulé E, Llaquet M, Muñoz-Peñalver J, Nart J, Hernández-Alfaro F, Gargallo-Albiol J. Mid-Term outcomes and periodontal prognostic factors Of autotransplanted third molars: A Retrospective Cohort Study. J Periodontol 2021; 92:1776-1787. [PMID: 33764523 DOI: 10.1002/jper.21-0074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/14/2021] [Accepted: 03/15/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Tooth autotransplantation is a valid method for replacing non-restorable teeth. This study aimed to assess mid-term survival and success of autotransplanted third molars and the clinical periodontal parameters and factors predicting successful periodontal attachment apparatus regeneration. METHODS In total, 36 patients who had undergone extraction and subsequent autotransplantation of 36 third molars using virtual planning and computer-aided rapid prototyping models by an oral surgeon and endodontist were eligible. Probing pocket depth (PPD), gingival recession (REC), clinical attachment level (CAL), pulpal and periapical healing, root resorption, and radiographic bone loss (RBL) were evaluated. Additionally, a questionnaire evaluated patient-reported outcomes. RESULTS The mean age of the participants was 30.2 years with a mean follow-up duration of 29.42 ± 14.56 months. The overall survival and success rates were 97.2% and 91.7%, respectively. No statistically significant differences were found in success and survival rates between open and closed apex groups or between compromised and intact buccal bone groups. No signs of pulp necrosis were found in the open apex group. Progressive replacement resorption was detected in one closed apex case. The mean PPD was 2.7 ± 0.45 mm for all transplanted teeth. REC was 0.13 mm higher in transplanted teeth than in previous hopeless teeth. CAL changes were neither clinically relevant (-0.17 ± 0.66 mm) nor statistically significant. The reported patient satisfaction was high. CONCLUSIONS Autotransplantation of third molars is a predictable treatment method, with a 2.5-year cumulative tooth survival and success of 97.2% and 91.7%, respectively, which were not influenced by recipient site integrity or root development.
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Affiliation(s)
- Ernest Lucas-Taulé
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marc Llaquet
- Department of Endodontics, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jesús Muñoz-Peñalver
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jordi Gargallo-Albiol
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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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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Kamio T, Kato H. Autotransplantation of Impacted Third Molar Using 3D Printing Technology: A Case Report. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 60:193-199. [DOI: 10.2209/tdcpublication.2018-0058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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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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Zufía J, Abella F, Trebol I, Gómez-Meda R. Autotransplantation of Mandibular Third Molar with Buccal Cortical Plate to Replace Vertically Fractured Mandibular Second Molar: A Novel Technique. J Endod 2017; 43:1574-1578. [DOI: 10.1016/j.joen.2017.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/10/2017] [Accepted: 03/16/2017] [Indexed: 02/02/2023]
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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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Atala-Acevedo C, Abarca J, Martínez-Zapata MJ, Díaz J, Olate S, Zaror C. Success Rate of Autotransplantation of Teeth With an Open Apex: Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2017; 75:35-50. [DOI: 10.1016/j.joms.2016.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/06/2016] [Indexed: 10/21/2022]
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Gilijamse M, Baart JA, Wolff J, Sándor GK, Forouzanfar T. Tooth autotransplantation in the anterior maxilla and mandible: retrospective results in young patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e187-e192. [DOI: 10.1016/j.oooo.2016.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/19/2016] [Accepted: 06/17/2016] [Indexed: 10/21/2022]
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Prognostic Factors for Clinical Outcomes in Autotransplantation of Teeth with Complete Root Formation: Survival Analysis for up to 12 Years. J Endod 2016; 42:198-205. [DOI: 10.1016/j.joen.2015.10.021] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 01/29/2023]
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Kovacs SB, Sheikh V, Thompson WL, Morcock DR, Perez-Diez A, Yao MD, Rupert AW, Utay NS, Roby G, Freeman AF, Estes JD, Sereti I. T-Cell Depletion in the Colonic Mucosa of Patients With Idiopathic CD4+ Lymphopenia. J Infect Dis 2015; 212:1579-87. [PMID: 25995198 PMCID: PMC4621254 DOI: 10.1093/infdis/jiv282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 03/30/2015] [Indexed: 12/14/2022] Open
Abstract
Idiopathic CD4(+) lymphopenia (ICL) is a rare syndrome characterized by low peripheral CD4(+) T-cell counts that can lead to serious opportunistic infections. The pathogenesis of ICL remains unclear, and whether effector sites are also lymphopenic is unknown. In this study, rectosigmoid mucosal biopsy specimens from patients with ICL and healthy controls were evaluated. Significant T-cell lymphopenia was observed in the mucosal tissue of patients with ICL by flow cytometry and immunohistochemistry, compared with healthy controls. Functional capacity of T cells, assessed by production of interferon γ and interleukin 17, was preserved in the mucosa of patients with ICL. In contrast to T lymphocytes, the frequency of myeloid cells (neutrophils and macrophages) was elevated in the colonic mucosa of patients with ICL. Despite the observed mucosal abnormalities, plasma levels of intestinal fatty acid binding protein, a marker of enterocyte turnover and other inflammatory biomarkers, including interleukin 6, C-reactive protein, and tumor necrosis factor, were not elevated in patients with ICL, compared with healthy controls, whereas soluble CD14 levels were minimally elevated. These data suggest that patients with ICL, despite gut mucosal lymphopenia and local tissue inflammation, have preserved enterocyte turnover and T-helper type 17 cells with minimal systemic inflammation. These observations highlight differences from patients with human immunodeficiency virus infection, with or without AIDS, and may partially explain their distinct clinical prognosis.
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Affiliation(s)
| | - Virginia Sheikh
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - William L. Thompson
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - David R. Morcock
- Retroviral Immunopathology Section, AIDS and Cancer Virus Program
| | - Ainhoa Perez-Diez
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Michael D. Yao
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Adam W. Rupert
- AIDS Monitoring Laboratory, Leidos Biomedical Research,Frederick National Laboratory for Cancer Research
| | - Netanya S. Utay
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical Branch, Galveston
| | - Gregg Roby
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Alexandra F. Freeman
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Jacob D. Estes
- Retroviral Immunopathology Section, AIDS and Cancer Virus Program
| | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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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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Lu L, Sun HF, Xue H, Guo J, Chen YX. Effects of orthodontic load on the periodontium of autogenously transplanted teeth in beagle dogs. J Zhejiang Univ Sci B 2013; 14:1025-32. [PMID: 24190448 DOI: 10.1631/jzus.b1300062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To observe the periodontal healing of autogenously transplanted teeth loaded orthodontically after autotransplantation in Beagle dogs. METHODS Forty-eight teeth were autogenously transplanted, 24 of which were loaded postoperatively with orthodontic force at different time points and for different durations. Periodontal healing was evaluated by probing pocket depth (PPD), the expression of relevant proteins, and histomorphometric analyses. RESULTS The dental pockets of loaded and non-loaded teeth were both much deeper after the first postoperative week than before transplantation (P<0.05). Later, the PPD, which was measured after postoperative weeks 1, 3, 5, 9 and 13, gradually became shallow. The expressions of alkaline phosphatase (ALP) and basic fibroblast growth factor (bFGF) were higher in loaded teeth than in non-loaded teeth (P<0.05), and in groups subjected to two weeks duration of loading than in other groups at the same load time point (P<0.05). For the same load duration, the expressions of ALP and bFGF in teeth loaded after postoperative week 4 were higher than those of other treatments (P<0.05). According to histomorphometric analyses, an orthodontic force on transplanted teeth applied after postoperative weeks 4 or 8 for two weeks duration should be favorable for periodontal healing. CONCLUSIONS It is advisable to apply an appropriate magnitude of force on autotransplanted teeth, such as orthodontic force, at appropriate time points and for a suitable duration, to achieve the optimal clinical prognosis following autogenous tooth transplantation. These results may serve as a basis for subsequent studies in humans so as to make clinical improvements.
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Affiliation(s)
- Lu Lu
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Shandong University, Jinan 250012, China; Shandong Provincial Key Laboratory of Oral Biomedicine, Shandong University, Jinan 250012, China; Department of Orthodontics, West China College of Stomatology, Sichuan University, Chengdu 610041, China
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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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Jang JH, Lee SJ, Kim E. Autotransplantation of immature third molars using a computer-aided rapid prototyping model: a report of 4 cases. J Endod 2013; 39:1461-6. [PMID: 24139275 DOI: 10.1016/j.joen.2013.06.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 05/25/2013] [Accepted: 06/04/2013] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Autotransplantation of immature teeth can be an option for premature tooth loss in young patients as an alternative to immediately replacing teeth with fixed or implant-supported prostheses. The present case series reports 4 successful autotransplantation cases using computer-aided rapid prototyping (CARP) models with immature third molars. METHODS The compromised upper and lower molars (n = 4) of patients aged 15-21 years old were transplanted with third molars using CARP models. Postoperatively, the pulp vitality and the development of the roots were examined clinically and radiographically. The patient follow-up period was 2-7.5 years after surgery. RESULTS The long-term follow-up showed that all of the transplants were asymptomatic and functional. Radiographic examination indicated that the apices developed continuously and the root length and thickness increased. The final follow-up examination revealed that all of the transplants kept the vitality, and the apices were fully developed with normal periodontal ligaments and trabecular bony patterns. CONCLUSIONS Based on long-term follow-up observations, our 4 cases of autotransplantation of immature teeth using CARP models resulted in favorable prognoses. The CARP model assisted in minimizing the extraoral time and the possible Hertwig epithelial root sheath injury of the transplanted tooth.
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Affiliation(s)
- Ji-Hyun Jang
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Continued root development of a surgically repositioned human incisor tooth germ. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e11-5. [DOI: 10.1016/j.oooo.2011.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/06/2011] [Accepted: 10/18/2011] [Indexed: 11/19/2022]
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Waikakul A, Punwutikorn J, Kasetsuwan J, Korsuwannawong S. Alveolar bone changes in autogenous tooth transplantation. ACTA ACUST UNITED AC 2011; 111:e1-7. [PMID: 21310346 DOI: 10.1016/j.tripleo.2010.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 11/01/2010] [Accepted: 11/02/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the alveolar bone formation after autogenous tooth transplantation by conventional radiographic method and digital subtraction radiography. STUDY DESIGN This retrospective study was done in 54 of 136 patients who received the third molar tooth transplantation and attended the first week, as well as the 1-, 3-, 6-, 9-, and 12-month follow-up. Postoperative periapical radiographs were subsequently evaluated by direct visual interpretation and digital subtraction radiography. The data were analyzed by using McNemar test and 1-way repeated-measure analysis of variance as well as Bonferroni multiple comparison. RESULTS Fifty-four cases of transplantation were studied. Most of them had normal wound healing. The direct radiographic interpretation and digital subtraction radiography found significant alveolar bone formation in the first-and the third-month follow-ups (P < .05). Lamina dura appeared in the third month and kept increasing until the sixth month. CONCLUSIONS Postoperative radiographs revealed the distinctive bone formation up to the third month. The clinical and radiographic assessment found that the third molar transplants could bear a normal chewing load within 3 months.
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Affiliation(s)
- Aurasa Waikakul
- Department of Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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