Effect of Root Canal Therapy on the Success Rate of Teeth with Complete Roots in Autogenous Tooth Transplantation

Autotransplantation of a Third Molar to Replace Compromised Molar With the Individual Three-Dimensional Printed Ultrasonic Osteotome: A Case Report

Tooth autotransplantation is widely used to replace congenitally missing teeth or teeth with irreversible damage. This case report presents a personalized ultrasonic osteotome that enables precise preparation, minimizes bone trauma, enhances the initial stability of the transplanted tooth, and contributes to a favorable prognosis. The procedure is as follows: a 25-year-old female patient presented with a porcelain-fused-to-metal crown on Tooth #19, which had detached due to severe decay, rendering the tooth unsalvageable. Tooth #32 exhibited mesial inclination, resulting in decay of Tooth #31. After presenting treatment plan, the patient provided informed consent by signing the necessary documentation to proceed with the autotransplantation of Tooth #32 to replace Tooth #19. Tooth #32 was extracted and immediately scanned chairside using a 3Shape scanner. A custom-designed, tooth root-shaped ultrasonic osteotome was fabricated using 3D printing technology to match the shape of Tooth #32. Tooth #19 was extracted using a minimally invasive technique. The alveolar socket of Tooth #19 was prepared using the customized 3D-printed ultrasonic osteotome and a computer-aided rapid prototyping resin model. Tooth #32 was then transplanted into the socket and secured with figure-eight suspension sutures. To prevent damage to bone cells and periodontal tissues from overheating during socket preparation, the ultrasonic osteotome was designed with a porous, water-cooled system, effectively addressing this issue. After 24 months of follow-up, the transplanted tooth met success criteria, with no signs of pathological radiolucency, root resorption, or pain in the donor tooth. The alveolar socket, prepared with the personalized ultrasonic osteotome, ensured an optimal fit for the donor tooth, maintaining its stability and minimizing postoperative complications. The use of 3D printing technology to create a personalized ultrasonic osteotome represents an innovative advancement in tooth transplantation, supporting the development of digital and minimally invasive techniques in this field.

Midterm outcomes of autogenous mature third molars transplantation into surgically created sockets: A retrospective cohort study

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.

Survival of retained permanent canines after autotransplantation: A retrospective cohort study

INTRODUCTION

After third molars, canines are the teeth most commonly affected by displacement and impaction. Although orthodontic surgical treatment represents the standard method for realignment of canines, autotransplantation (autoTX) functions as the second-line therapy if orthodontic alignment does not succeed in treating impaction and severe displacement. This retrospective cohort study aimed to identify clinical predictors for postoperative survival and endodontic treatment needs after autoTX of severely displaced and impacted canines.

METHODS

The study cohort comprised patients who received canine autoTX in a single surgical center between 2006 and 2018. Canines with severe displacement and retention were surgically treated using a standardized protocol. Statistical analysis of survival probability was performed with the Kaplan-Meier method, and bivariate data were analyzed using logistic regression and the Pearson chi-square test. Nonparametric continuous variables were analyzed using the Mann-Whitney U test.

RESULTS

Data from 319 patients with 378 canine grafts were available for analysis after a mean follow-up of 54.7 ± 36.5 months on the patient level (range, 0.3-181.8 months). With 25 lost autotransplants, the cumulative survival rate was 93.4%. Patient age at surgery, the state of the apical foramen, endodontic treatment need, and persistence of deciduous teeth at the implantation site had a significant negative impact on autotransplant survival (P <0.05). Endodontic treatment need was significantly related to the patient's age at surgery, the state of the apical foramen, and preoperative orthodontic traction (P <0.05). Thus, these independent variables were identified as clinical predictors for the survival of both the autotransplant and the dental pulp. Gender, ischemia time, postoperative ankylosis, or site of autoTX did not influence any of the outcome variables.

CONCLUSIONS

The high survival rates of autotransplanted permanent canines make this treatment a promising option, especially in patients with severe tooth displacement, in which orthodontic treatment alone cannot provide predictable alignment, irrespective of the patient's age. Interpreting age and preoperative orthodontic traction as delaying the onset of autoTX and state of apex, time-dependent aspects seem to be of great importance for postoperative complications leading to endodontic treatment or graft loss. Therefore, early implementation of autoTX as a treatment modality for impacted, severely displaced, and vain exposed canines in daily surgical practice should be encouraged.

Effects of cryopreservation on the biomechanical properties of dentin in cryopreserved teeth: An in-vitro study

This study focused on the biomechanical properties and microstructural changes in dentin of teeth in different age groups after cryopreserved for different durations. Ninety third molars from three age groups (youth group, middle-age group, and elderly group), were collected and randomly divided into three groups according to freezing time at -196 °C (7 days, 30 days, and 90 days). Control group was shored at ordinary temperature. After rewarming, the compressive strength and elastic modulus of the dentin were measured with an electronic universal tester. Scanning electron microscopy was used to evaluate the microstructure of dentin after cryopreservation. After cryopreservation, the compressive strength of the teeth in each experimental group was not significantly different from control group. With the increase of freezing time and age, dentin's elastic modulus showed a decreasing trend. There were statistically significances between the control group and freezing 90d group, freezing 7d and 90d group, youth and middle-aged group, youth and elderly group (P < 0.05). Both freezing time and age factors were significant for the elastic modulus of dentin(P＜0.05). There was no interaction effect for age and freezing time. In transverse sections of scanning electron microscopy, the dentinal tubule became narrower, partially occluded, and more easily adhered to impurities in the long freezing time and elderly group. In longitudinal sections, with freezing time and age, the inner wall of the dentinal tubules became rough especially in the aged group cryopreserved for 90 days. No significant microcracks exited in any of the longitudinal sections of dentin.

Immediate Tooth Autotransplantation with Root Canal Filling and Partially Demineralized Dentin/Cementum Matrix into Congenital Missing Tooth Region

This clinical report describes immediate tooth auto-transplantation with an autograft of partially demineralized dentin/cementum matrix (pDDM), based on an orthodontic treatment plan for a 16-year-old male patient with a congenital missing tooth (#45). First, vital teeth (#14, #24) were extracted, and root canal filling (#14) was immediately performed with the support of a fixation device. Simultaneously, the tooth (#24) was crushed in an electric mill for 1 min, and the crushed granules were partially demineralized in 2% HNO₃ solution for 20 min as the graft material. Next, the donor tooth was transplanted into the created socket (#45), and stabilized using an enamel bonding agent. The wet pDDM was loaded into the location of the congenital missing tooth, and the flap was repositioned. The bonding agent for stabilization was removed at 28 days, and also small contact points between the transplanted tooth and the upper premolar (#14) were added using photopolymerizable composite resin. X-ray photos were taken sequentially, and there were no postoperative complications. The radiographic images showed that the periodontal ligament space and alveolar ridge line could be observed at 18 months. The pDDM was harmonized with the mandible, and the remodeled bone-like shadow was observed in the graft region. We concluded that immediate tooth transplantation with root canal fillings and autogenous pDDM may be a valuable alternative to dental implanting or bridge formation for patients with a congenital missing tooth, followed by orthodontic treatment.

Review of Cracked Tooth Syndrome: Etiology, Diagnosis, Management, and Prevention

Cracked tooth syndrome refers to a series of symptoms caused by cracked teeth. This article reviews the current literature on cracked tooth syndrome from four aspects, etiology, diagnosis, management, and prevention, to provide readers integrated information about this. The article begins with an introduction to the odontiatrogenic factors and then covers the noniatrogenic factors that induce cracked tooth syndrome. While the former discusses inappropriate root canal therapy and improper restorative procedures, the latter covers the topics such as the developmental and functional status of cracked tooth syndrome. This is then followed by the description of common clinical diagnosis methods, the prospects of new technologies, and summaries of current clinical management methods, including immediate management and direct and indirect restoration. In the final section, preventive methods and their importance are proposed, with the aim of educating the common population.