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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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Tovío-Martinez E, Urbano Del Valle S, Gamarra-García J. Autologous transplant third mandibular molar in post extraction socket. Case report. DUAZARY 2020. [DOI: 10.21676/2389783x.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dental transplantation is a surgical alternative, which consists of transplanting a tooth from one alveolus to another in the same patient, very useful when replacing lost dental organs in young patients, with a high success rate. Present advantages helpful for patients providing a vital, proprioceptive and excellent aesthetic rehabilitation, without altering adjacent teeth, additionally represents an alternative cheaper. The purpose of this case report is to show clinical sequence about surgical approach for dental autotransplantation from lower third molar on alveolus after extraction of right lower first molar, carried out without endodontic treatment. Female patient case of 15 years old with a diagnosis of extensive caries not restorable in 46 is presented. It is decided through an interdisciplinary board to carry out, treatment with an autologous transplant of right lower third molar in socket post-extraction of first lower molar from the same hemiarchate, post-surgical controls are performed for up to one year. Dental transplantation is an excellent treatment option when it comes to replacing missing teeth, since it offers multiple functional and aesthetic advantages, mainly in children and young adults.
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Rodrigues MDP, Soares PBF, Gomes MAB, Pereira RA, Tantbirojn D, Versluis A, Soares CJ. Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 2020; 28:e20190544. [PMID: 32348440 PMCID: PMC7185981 DOI: 10.1590/1678-7757-2019-0544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.
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Affiliation(s)
- Monise de Paula Rodrigues
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Priscilla Barbosa Ferreira Soares
- Departamento de Periodontia e Implantologia, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Márcio Alex Barros Gomes
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Renata Afonso Pereira
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Daranee Tantbirojn
- Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Antheunis Versluis
- Department of Memphis, College of Dentistry, University of Tennessee Health Science Center, Tennessee, USA
| | - Carlos Jose Soares
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
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Mena-Álvarez J, Riad-Deglow E, Quispe-López N, Rico-Romano C, Zubizarreta-Macho A. Technology at the service of surgery in a new technique of autotransplantation by guided surgery: a case report. BMC Oral Health 2020; 20:99. [PMID: 32264867 PMCID: PMC7140495 DOI: 10.1186/s12903-020-01095-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/27/2020] [Indexed: 12/17/2022] Open
Abstract
Background The aim of this case report was to use a surgical technique for autotransplantation of tooth using virtually planned 3D printed surgical templates for guided osteotomy preparation of the recipient of donor tooth. Case presentation An 18-year-old male patient received autotransplantation of the right mandibular third molar to replace an included right second molar. This procedure was based on guided implant surgery methods by superimposition of DICOM files and 3D data sets of the jaws. In order to design a 3D-printed template with the aid of a fully digital workflow; the third molar was conserved in PRGF during the surgical procedure and the tooth socket was prepared with a template and the help of a 3D-printed donor tooth copy in order to prevent iatrogenic damage to the donor tooth. This template and replica were manufactured using 3D-printing techniques. The transplanted tooth was placed in infra-occlusion and fixed with a suture splint and root canal therapy was performed 15 days later. The intervention was be accomplished by performing preplanned virtual transplantations with guided osteotomies to ensure accurate donor tooth placement in the new recipient site. The 24 months follow-up showed physiological clinical and radiologic results compatible with healing periradicular tissues. Conclusions This approach enables the planning and production of a 3D printed surgical template using the latest diagnostic methods and techniques of guided implant surgery. These accurate virtually predesigned surgical templates and printed analogues of the donor tooth could facilitate autotransplantation, ensuring an atraumatic surgical protocol.
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Affiliation(s)
- J Mena-Álvarez
- Head Academic, Master Degree in Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, Madrid, Spain.
| | - E Riad-Deglow
- Associate professor, Master Degree in Implants, Faculty of Health Sciences, Alfonso X el Sabio University, Madrid, Spain
| | - N Quispe-López
- Associate professor, Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, Madrid, Spain
| | - C Rico-Romano
- Associate professor, Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, Madrid, Spain
| | - A Zubizarreta-Macho
- Associate professor, Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, Madrid, Spain
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Application of Platelet-Rich Fibrin as Regeneration Assistant in Immediate Auototransplantation of Third Molar with Unformed Roots: Case Report and Review of Literature. Case Rep Dent 2020; 2020:8170646. [PMID: 32089902 PMCID: PMC6996676 DOI: 10.1155/2020/8170646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/24/2023] Open
Abstract
Background Autogenous Tooth Transplantation (ATT) is the surgical movement of a maturely or immaturely formed tooth from its original site to another extraction site or a surgically prepared socket in the same individual. The most important factor in the healing process after autotransplantation is the presence of intact and viable periodontal ligament cells, which have the ability to differentiate into osteoblasts and able to induce bone production. ATT can successfully replace removable dentures as a restoration option in a growing patient, while implants can be placed only after skeletal maturity is attained. Case Presentation. In this case, we presented an immediate ATT of the third molar with unformed roots to the extraction socket of the first molar with evidence of continued root formation after 2 years of follow-up. Conclusion Platelet-Rich Fibrin (PRF) can induce sustainable and accelerated healing, and it can also induce the regeneration process of the periodontal tissues and pulpal formation. This process plays a key role in future root development and success rate.
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Gaviño Orduña JF, García García M, Dominguez P, Caviedes Bucheli J, Martin Biedma B, Abella Sans F, Manzanares Céspedes MC. Successful pulp revascularization of an autotransplantated mature premolar with fragile fracture apicoectomy and plasma rich in growth factors: a 3-year follow-up. Int Endod J 2019; 53:421-433. [PMID: 31587320 DOI: 10.1111/iej.13230] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022]
Abstract
AIM This case report demonstrates a positive outcome of the adjuvant use of fragile fracture (FF), which is a technique used to harvest dental pulp stem cells (DPSCs), and platelet-rich plasma (PRP) in a mandibular premolar (tooth 44) with a completely formed root that was transplanted into a surgically created socket and which maintained pulp vitality and function. SUMMARY After virtual surgical planning, a 3D tooth replica of tooth 44 was fabricated. A surgical socket was created in the position of tooth 14; then, tooth 44 was extracted and the root dentine was abraded using a turbine diamond bur 3 mm from the apex until a circular groove was prepared around the outer circumference of the root; and then, an FF was performed without damaging the pulp tissue. PRP was placed in the socket, after which the donor tooth was inserted in the recipient area. At 2 weeks post-treatment, orthodontic traction was applied. At 3-year follow-up, the tooth had adequate alignment and was asymptomatic. Response to pulp testing was positive, and the presence of pulp canal obliteration was observed as a sign of pulpal healing. KEY LEARNING POINTS Autotransplantation is a good alternative for replacing missing teeth, with repair of tissues and pulp revascularization. Revascularization of an autotransplanted mature tooth using the fragile fracture technique and PRP scaffold is a feasible option and might have positive effects on the long-term outcome of the procedure. Including completely formed teeth as donors in autotransplantation, maintaining vitality and their functions is an option that warrants further study.
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Affiliation(s)
- J F Gaviño Orduña
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - M García García
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - P Dominguez
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - J Caviedes Bucheli
- Centro de Investigaciones Odontologicas (CIO) Pontificia, Universidad Javeriana, Bogota, Colombia
| | - B Martin Biedma
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - F Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - M C Manzanares Céspedes
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain.,Department of Experimental Pathology and Therapeutics, School of Medicine, University of Barcelona, Barcelona, Spain
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Jakobsen C, Stokbro K, Kier-Swiatecka E, Ingerslev J, Thorn J. Autotransplantation of premolars: does surgeon experience matter? Int J Oral Maxillofac Surg 2018; 47:1604-1608. [DOI: 10.1016/j.ijom.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/26/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
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He W, Tian K, Xie X, Wang E, Cui N. Computer-aided autotransplantation of teeth with 3D printed surgical guides and arch bar: a preliminary experience. PeerJ 2018; 6:e5939. [PMID: 30498633 PMCID: PMC6252245 DOI: 10.7717/peerj.5939] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/16/2018] [Indexed: 12/19/2022] Open
Abstract
Background/Aim Autotransplantation of teeth is a method to restore the missing teeth and computer-aided techniques have been applied in this field. The aim of this study was to describe a novel approach for computer-aided autotransplantation of teeth and to preliminarily assess its feasibility, accuracy, and stability. Methods Eight wisdom teeth with complete root formation of eight adult patients were autotransplanted. Individual replicas of donor teeth with local splints, surgical templates, and arch bars were virtually designed and fabricated using three-dimensional printing, these were then applied in the autotransplantation surgeries. Clinical and radiological outcomes were observed, the extra-alveolar time, success rate, and 1-year survival rate were analyzed, and accuracy and stability of this approach were evaluated. Results The extra-alveolar time of donor teeth were less than 3 min. The average follow-up duration was 2.00 ± 1.06 years. All autotransplanted teeth showed normal masticatory function. Ankylosis was found in one patient, and the overall success rate was 87.5%, whereas the 1-year survival rate was 100%. Linear differences between the designed and the immediate autotransplanted positions at crowns and apexes of the donor teeth were 1.43 ± 0.57 and 1.77 ± 0.67 mm, respectively. Linear differences between immediate and the stable positions at crowns and apexes of the donor teeth were 0.66 ± 0.36 and 0.67 ± 0.48 mm, respectively. Conclusion The present study illustrated the feasibility, clinical satisfied accuracy, and stability of a novel approach for computer-aided autotransplantation of teeth. This new approach facilitated the surgical procedure and might be a viable and predictable method for autotransplantation of teeth.
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Affiliation(s)
- Wei He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Kaiyue Tian
- Department of Oral and Maxillofacial Plastic and Traumatic Surgery, Capital Medical University School of Stomatology, Beijing, China
| | - Xiaoyan Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Enbo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Nianhui Cui
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
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