RESUMEN
Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root resorption of tooth 3.7. Extraction of 3.7 and autotransplantation of 3.8 was planned, following a 6-week orthodontic phase for periodontal ligament activation and teeth mobilization. Due to the different root morphology between the compromised and donor teeth and the high mandibular bone density, the receiving socket preparation was performed using guided surgery templates. Two surgical splints were designed with a surgical planning software. Tooth 3.7 was extracted, the recipient site was guided-milled, and tooth 3.8 was transplanted into the new socket in approximately one second of extra-alveolar time. The rapidity of the extra-alveolar time facilitated complete healing without resorting to root canal treatment. Five-year radiological control does not show any periapical lesion or root resorption. The surgical procedure for tooth autotransplantation is fundamental: it must be as atraumatic as possible to preserve the periodontal ligament of the tooth and the receiving socket, and the dentist must minimize the extra-alveolar time. Guided surgery is a reliable solution to combine all these aspects.
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Background and Overview. Socket shield is a technique that allows the maintenance of tissue volumes. In the reported clinical case, the replantation of the buccal root fragment mistakenly extracted during a socket shield surgery is performed. We present a follow-up to 5 years with an unexpected healing.Case Description. An 88-year-old patient underwent an immediate loading implant placement associated with the replantation of the mistakenly extracted root fragment. The shaping of the fragment was performed extraorally, and the replantation was done so that the fragment protruded above the crest margin.Conclusions and Practical Implications. The 5-year follow-up shows an uneventful healing of the implant. At 48 months, postoperative CBCT exam reports images compatible with the regeneration of the bone over the portion of root that protruded over the margin. The outcome suggests clinical implications, as the opportunity to easily shape the fragment extraorally and replant sound portion of the root (not necessary the buccal) in buccal socket with bone defect.
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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.
Asunto(s)
Tercer Molar , Fístula Oroantral , Comunicación , Humanos , Seno Maxilar , Tercer Molar/cirugía , Trasplante AutólogoRESUMEN
OBJECTIVE: The replacement of an irremediably compromised tooth requires an implant rehabilitation or a traditional fixed partial denture. In well-selected cases, a further therapeutic possibility is represented by tooth autotransplantation. Although dental transplants are poorly understood and practiced, the international literature agrees that it is considered the first choice when applicable. The advantages of this technique are numerous: use of an autologous element, maintenance of tissue trophism, aesthetic and functional restoration, costs reduction. Although autotransplantation is often performed with immature teeth, even mature teeth with fully formed apex can be used as donors. The aim of the present work was to analyze consecutive cases of completely formed donor teeth autotransplantations performed from 2005 to 2011 in 21 patients for evaluating the survival and success rate. MATERIALS AND METHODS: The medical records of patients who underwent transplantation in a specialized center in Rimini (Italy) from 2005 to 2011 were checked. Only transplants of mature donor molars were considered. Patients were called up to evaluate the survival rate and success rate. RESULTS: The mean age at the time of the surgery was 33,6 ±â¯7,4;â¯mean follow up was 11,9 years ±1,9. Success rate at the time of latest recall visit was 80 % and survival 95 % of the analyzed cases. CONCLUSIONS: The survival and success rate are in complete agreement with the most recent literature and confirm that the technique of autotransplantation is reliable when indications and protocols are rigidly followed, also using mature teeth as donors.
Asunto(s)
Diente , Niño , Estudios de Seguimiento , Humanos , Italia , Estudios Retrospectivos , Trasplante Autólogo , Resultado del TratamientoRESUMEN
BACKGROUND AND OVERVIEW: In this case report, the authors aim to review the standard protocols for endodontic treatment of autotransplanted molars and report on the 5-year follow-up of a clinical transplantation case. CASE DESCRIPTION: The authors transplanted a mandibular third molar into the position of the adjacent second molar. The authors performed extraoral apicoectomy and retrograde restoration after atraumatic extraction of the donor tooth and before transplantation. The authors did not perform conventional orthograde root canal treatment after transplantation. The patient was followed up 5 years after the autotransplantation. Results of follow-up radiography showed a regular root surface without evidence of periapical lesions or root resorption. CONCLUSIONS AND PRACTICAL IMPLICATIONS: If appropriate sterility of the working field is maintained during surgery and a tight apical seal is achieved during the extraoral treatment, orthograde endodontic treatment should be delayed or avoided.