Bone augmentation and autogenous transplantation of premolar to the site of the fissure in a cleft palate patient

Replantation of a displaced incisor in a boy with a cleft lip and alveolus: a case report

BACKGROUND

Tooth replantation after traumatic avulsion or transplantation is a challenge in oral surgery. A special method named auto-alloplastic replantation, in which a titanium post is used after extraoral endodontic treatment, combines several advantages. The treatment is performed in one step with no further endodontic intervention, no wide root canal instrumentation, no recontamination, and reduced endodontic infection. This is the first report on replantation of an ectopic tooth in a patient with a cleft lip and alveolus using this method.

CASE PRESENTATION

This case report presents the treatment of a 13-year-old white boy with a cleft lip and alveolus who had an ectopic incisor in the cleft region. His rehabilitation was performed by a tooth transposition using the auto-alloplastic replantation technique. After preparation of the displaced incisor from the vestibule, extraoral endodontic treatment followed using a titanium post prior to replantation in a newly formed socket. In the follow-up, the tooth is still in place and functioning after 2 years.

CONCLUSIONS

This method can be used to bridge the years while a patient is young and jaw growth is incomplete until bone augmentation and implantation can be performed. The tooth will preserve the remaining alveolar ridge and help the adolescent psychologically.

Secondary bone grafting with simultaneous auto-tooth transplantation to the alveolar cleft

One of the most important purposes of secondary bone grafting of the alveolar cleft is to stabilize the maxillary alveolar arch with completion of the dental arch. We report a case of secondary bone grafting with simultaneous auto-tooth transplantation to the alveolar cleft, using particulate cancellous bone and marrow (PCBM) combined with platelet-rich plasma (PRP), which contains many growth factors. The patient was born with a bilateral cleft lip and left buccal-localized cleft alveolus. We performed bone grafting to the cleft using PCBM with PRP and transplantation of the supernumerary tooth under general anesthesia when the patient was aged 11 years, 10 months. The postoperative course was uneventful and without any complications. The orthodontic treatment was nearly complete 10 months after the operation. The transplanted tooth was stable, and a normal gingival contour was attained during the 2-year follow-up period. The case was successful in achieving a stable occlusal condition within a short period. We suggest secondary bone grafting with simultaneous auto-tooth transplantation as an option for alveolar cleft treatment.