National clinical guidelines for the management of unerupted maxillary incisors in children.

This article summarises recently updated guidelines produced by the Clinical Governance Directorate of the British Orthodontic Society through the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS) on the management of unerupted maxillary incisor teeth in children. The maxillary incisor teeth usually erupt in the early mixed dentition but eruption disturbances can occur and are often attributable to local factors. A failure of eruption will affect the developing occlusion and potentially influence psychological development of the child. The general principles of management for delayed eruption or impaction of these teeth is to ensure that adequate space exists in the dental arch and to remove any obstruction to eruption. Consideration should also be given to further promoting eruption through surgical exposure of the incisor, with or without subsequent orthodontic traction. A number of factors influence the decision-making process, including patient age, medical history, potential compliance, aetiology and position of the unerupted incisor. Treatment planning should be complemented by careful clinical assessment and the use of appropriate special investigations. To optimise the treatment outcome a multidisciplinary specialist approach is recommended.

Trasplantes dentarios / Tooth transplantations

La reubicación de un órgano dentario de un lado a otro de la boca en el mismo paciente (trasplante autólogo), ha demostrado a través de la historia ser un procedimiento sencillo, económico y útil para sustituir órganos dentarios lesionados por caries o ausentes. Su técnica, indicaciones y algunas consideraciones de tratamiento se ilustran con un caso representativo

Autogenic tooth transplantation: a report of ten cases.

Modifications in the surgical procedure for transplantation of the unerupted mandibular third molar to the first molar socket are presented, and the clinical and radiographic data on ten cases with a 3-year follow-up are described. The proposed method of treatment makes it possible to stabilize the transplant without a splint by using a suture crossed over the occlusal surface of the tooth.

Proliferation of pulpal tissues following early transplantation of developing teeth.

The responses of pulpal tissues were assessed histologically in teeth that had been transplanted as soon as crown formation was completed. The teeth were unerupted at the time of surgery and were transferred to other bony crypts, where attempts were made to reproduce their natural alignment. The pulpal tissues remained viable, although variations occurred in cellularity, vascularity and texture. There was widespread production of intrapulpal bone and osteodentine, and confluence of these tissues with proliferating apical and adjacent bone often resulted in ankylosis. The view was supported that transplanted dental tissues have a strong likelihood of surviving if the procedure is undertaken relatively early during tooth development; however, structural variations and ankylosis may compromise their subsequent value.

A radiographic assessment of autologous tooth transplants in dogs.

This study assessed structural and functional changes that occurred when teeth in dogs were transplanted at various stages of development. Unerupted developing permanent teeth were transferred to other existing bony crypts or to surgically prepared bony sockets. Erupted teeth with varying degrees of root formation were transplanted to other sockets, some with increased functional influences. The development, morphologic features, and relationships of the transplanted teeth were assessed radiographically at intervals ranging from seven to 150 days postoperatively.