Multiple effects of dose-related GM-CSF on periodontal resorption in deep-frozen grafted teeth: A reverse study.

Autologous tooth grafting is a dental restorative modality based on periodontal ligament healing.Human periodontal ligament stem cells(PDLSCs) are involved in the formation and remodeling of periodontal tissue.Based on previous findings, the proliferation and differentiation of processing cryopreserved periodontal ligament stem cells (PDLSCs) exhibit similarities to those of fresh cells. However, there is evident absorption in the transplanted frozen tooth's roots and bones, with the underlying cause remaining unknown. Granulocyte macrophage colony-stimulating factor(GM-CSF) is named for its produce granulocyte and macrophage precursors from bone marrow precursors, and it also serves as one of the regulatory factors in inflammatory and osteoclast formation. This study aimed to investigate changes in GM-CSF expression in frozen PDLSCs (fhPDLSCs) and evaluate the impact of GM-CSF on PDLSCs with respect to cellular activity and osteogenic ability. The role of GM-CSF in periodontal absorption was further speculated by comparing with IL-1ß. The results revealed a significant increase in GM-CSF levels from fhPDLSCs compared to fresh cells, which exhibited an equivalent inflammatory stimulation effect as 1 ng/ml IL-1ß. Cell viability also increased with increasing concentrations of GM-CSF; however, the GM-CSF from fhPDLSCs was not sufficient to significantly trigger osteoclastic factors. Considering its interaction with IL-1ß and positive feedback mechanism, environments with high doses of GM-CSF derived from fhPDLSCs are more likely to activate osteoclastic responses.Therefore, for frozen tooth replantation, great attention should be paid to anti-inflammation and anti-infection.GM-CSF may serve as a potential therapeutic target for inhibiting periodontal resorption in delayed grafts.

Autotransplante dentário: da previsibilidade à técnica cirúrgica e resultados do tratamento / Dental Autotransplantation: from predictability to surgical technique and treatment results

Objetivo: apresentar o relato de duas pacientes com agenesias dentárias em que cinco dentes autotransplantados foram utilizados como modalidade de tratamento. Além disso, objetiva-se mostrar questões sobre a técnica cirúrgica, suas indicações e previsibilidade. Relato de caso: Neste estudo, foram relatados 5 casos de autotransplante dentário em duas pacientes jovens, em que a equipe realizou os procedimentos e o acompanhamento clínico e radiográfico por 5 e 7 anos. Devido à alta sensibilidade da técnica, foram seguidos princípios previamente estabelecidos na literatura envolvendo o autotransplante dentário. Durante o período de acompanhamento, os dentes se mantiveram em posição e em função e as pacientes não apresentavam queixas associadas. Considerações finais: a técnica do autotransplante dentário, quando bem indicada e executada, é capaz de promover resultados bastante satisfatórios, sendo uma ótima alternativa reabilitadora, com taxas de sucesso elevadas e custos reduzidos. No entanto, critérios em relação aos sítios doadores e receptores e a habilidade do cirurgião devem ser levados em conta para o sucesso do técnica.

Objective: presenting the report of two patients with tooth agenesis in which five autotransplanted teeth were used as a treatment modality. Furthermore, the aim is to show questions about the surgical technique and its indications and predictability. Case report: In this study, 5 cases of dental autotransplantation were reported in two young patients, in which the team performed procedures and had clinical and radiographic follow-up for 5 and 7 years. Due to the high sensitivity of the technique, principles previously established in the literature involving dental autotransplantation were followed. During the follow-up period, the teeth remained in position and function and the patients had no associated complaints. Final considerations: the dental autotransplantation technique, when well indicated and executed, is capable of achieving very satisfactory results, being a great rehabilitative alternative, with high success rates and reduced costs. However, criteria regarding donor and receptor sites and the surgeon's skill must be taken into account for the success of the technique.

Identifying important prognostic factors and outcomes for autotransplantation of developing teeth: Clinicians' perspectives.

BACKGROUND/AIM: Variability in the outcome measures used to assess the success of tooth autotransplantation presents challenges for combining data to examine the success of the technique. Reaching agreement on the most important outcomes will enable routine procedural and follow-up data to be collected in a standardised way. In turn this will promote greater data synthesis to evaluate outcomes and examine which procedural techniques influence outcome. The aim of this study was to identify which prognostic factors and outcomes are most important to clinicians with experience in autotransplantation of developing teeth. METHODS: The Delphi method was used to build consensus on the most important prognostic factors and outcomes. Item identification involved a systematic literature review and review of current clinical datasets in use. A two-round Delphi questionnaire was undertaken with clinicians providing tooth autotransplantation, followed by a consensus meeting to finalise the most important items. RESULTS: Outcomes and prognostic factors were identified from the systematic review (82 studies and eight reviews), one guideline and three existing clinical datasets. Patient interviews and a clinician survey added a number of items that would not have been identified from the literature only. A total of 56 outcomes and 93 prognostic factors were included for rating in the Delphi questionnaire. The Delphi questionnaire was completed by 15 respondents in round one and 13 respondents in round two. The consensus meeting was attended by nine participants. The final items that were judged to be most important included 29 outcomes (25 clinical, three patient-reported and one service delivery) and 49 prognostic factors (18 patient characteristics, four presurgical, 17 surgical and 10 postsurgical). Clinical outcomes were consistently rated higher than patient-reported outcomes. CONCLUSIONS: The clinical outcomes rated as the most important were transplant survival and reason for failure, outcomes relating to pulp health, different types of resorption and evidence of infection (suppuration). Important patient-reported outcomes were satisfaction with overall treatment experience, and outcome and quality of life related to function of the transplanted tooth. Procedural information rated as being the most important related to the donor tooth: stage of root development, method for surgical removal and storage and condition of the donor tooth root surface following removal.

Tooth autotransplantation: An umbrella review.

Tooth autotransplantation is a versatile procedure with several clinical applications among patients across different age groups. The success of this procedure depends on multiple factors. Despite the wealth of studies available, no single primary study or systematic review is able to report on every factor affecting the outcomes of autotransplantation. The aims of this umbrella review were to evaluate treatment-related and patient-related outcomes of autotransplantation and to assess the pre-, peri- or post-operative factors that could affect these. An umbrella review was conducted according to the PRISMA statement. A literature search of five databases was performed up to 25 September 2022. Systematic Reviews (SR) with and without meta-analysis evaluating autotransplantation were included. Calibration among reviewers was carried out prior to study selection, data extraction and Risk of Bias (RoB) assessment. Study overlap was calculated using corrected covered area. Meta-meta-analysis (MMA) was performed for suitable SRs. The AMSTAR 2 critical appraisal tool was used to evaluate the quality of evidence. Seventeen SRs met the inclusion criteria. Only two SRs were suitable for conduct of MMA on autotransplantation of open apex teeth. The 5-year and 10-year survival rates were >95%. A narrative summary on factors that could affect autotransplantation outcomes and comparisons of autotransplantation to other treatment options were reported. Five SRs were rated as 'low quality' and 12 SRs were rated as 'critically low quality' in the AMSTAR 2 RoB assessment. In order to facilitate a more homogenous pool of data for subsequent meta-analysis, an Autotransplantation Outcome Index was also proposed to standardise the definition of outcomes. Autotransplantation of teeth with open apices have a high survival rate. Future studies should standardise the reporting of clinical and radiographic findings, as well as the definition of outcomes.

Long term outcomes of en-block autotransplantation of a tooth.

Repositioning of impacted teeth in the dental arch through en-bloc autotransplantation showed short-term efficacy of 89%. The objective of this study was to evaluate the technique for long-term efficacy. The analysis involved 23 teeth transplanted to the alveolar ridge through harvesting the tooth with the adjacent bone tissue. Development of the root was completed and the apical foramen was closed in all the teeth. The teeth were examined clinically and radiologically (CBCT) and compared to contralateral ones. The obtained data were analysed statistically. The efficacy of the procedure amounted to 81% including two teeth lost at an early stage and another two lost during follow-up. The mean age of patients upon performing the procedure was 29.8. The long-term follow-up amounted to the mean of 34.3 months. In the study group recession of 1-2 mm as well as 3-5 mm was found, which was not noted on the control group. In 11.1% of the study group teeth the external root resorption was observed. No transplanted tooth underwent root canal treatment, no periapical changes were observed at CBCT and 77.8% of those showed positive reaction to ethyl chloride. One case of ankylosis was observed in tooth 11 and in two cases increased mobility of the transplanted tooth was found. Regeneration of nerves as well as revascularization in the en-bloc autotransplantation proceeded with high predictability and the risk of ankylosis of the treated tooth seemed to be negligible. Gingival recession was observed more often in case of en-bloc transplantation compared to the control group. The long-term follow-up suggested that this the technique does not prevent external resorption in 100%.

Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months.

Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.

[Screening and analysis of prognostic factors of repairing single missing tooth by autotransplantation of teeth].

Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (ß=-2.812, P=0.049), alveolar bone height (ß=1.521, P=0.020), donor time (ß=-2.001, P=0.019), use of donor model (ß=1.666, P=0.034) and initial stability (ß=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.

Autotransplantation of teeth with incomplete root formation: systematic review and meta-analysis.

OBJECTIVES: To determine the survival of intentional autotransplantation of developing teeth. MATERIAL AND METHODS: An electronic search was carried out in the MEDLINE database, Web of Science, and Cochrane Library. The criteria used are the ones described in the PRISMA Declaration. The following MeSH terms were used: ("tooth" [MeSH Terms] OR "tooth" [All Fields]) AND ("transplantation, autologous" [MeSH Terms] OR ("transplantation" [All Fields] AND "autologous" [All Fields]) OR "autologous transplantation" [All Fields] OR "autotransplantation" [All Fields]) AND ("humans" [MeSH Terms]. Randomised clinical trials and prospective and retrospective clinical studies were included. RESULTS: The meta-analytic study of overall survival included a total of 14 studies, yielding an overall survival rate of 97.9%. In studies with 1-year follow-ups, survival was 98%. The resulting 2-year follow-up rate was 97%, while the 5- and 10-year survival rates were 95.9% and 96.9%, respectively. CONCLUSIONS: The autotransplantation technique performed in a single-phase and on teeth that have not completed their development is a predictable technique, with a described survival rate at a 2-year follow-up of more than 97%. CLINICAL RELEVANCE: The technique of dental autotransplantation is considered an important resource for the resolution and rehabilitation of tooth loss in patients, especially in those who are still in a growth period. Moreover, this technique has a low complication rate and a 10-year survival rate of 96.9%. It should therefore be considered a safe and reliable procedure.

Screening and analysis of prognostic factors of repairing single missing tooth by autotransplantation of teeth / 中华口腔医学杂志

Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (β=-2.812, P=0.049), alveolar bone height (β=1.521, P=0.020), donor time (β=-2.001, P=0.019), use of donor model (β=1.666, P=0.034) and initial stability (β=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.

The influence of storage temperature on fracture behavior of cryopreserved teeth-An in vitro study.

OBJECTIVES: Cryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long-term prognosis of the teeth. MATERIAL AND METHODS: Twenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at -80°C (group 1) and -196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load. RESULTS: No significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests. CONCLUSIONS: Conclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.

Poly lactic-co-glycolic acid scaffold loaded with plasmid DNA encoding fibroblast growth factor-2 promotes periodontal ligament regeneration of replanted teeth.

OBJECTIVE: This study investigated the effects of poly lactic-co-glycolic acid (PLGA) loaded with plasmid DNA encoding fibroblast growth factor-2 (pFGF-2) on human periodontal ligament cells (hPDLCs) in vitro and evaluated the ability of the PLGA/pFGF-2 scaffold to promote periodontal ligament (PDL) regeneration in a beagle dog teeth avulsion animal model. BACKGROUND: Growth factor and scaffold play important roles in PDL regeneration. PLGA is a kind of biodegradable and biocompatible polymer that can be used as a carrier to deliver growth factors or genes. FGF-2 can induce potent proliferative responses, promote cell migration and regulate the production of extracellular matrix. Therefore, a gene-activated matrix composed of scaffold and genes is supposed to be a superior approach for promoting tissue regeneration. METHODS: In this study, PLGA and PLGA/pFGF-2 scaffolds were fabricated using electrospinning. The characterization of scaffolds was shown by scanning electron microscope (SEM) and transmission electron microscope (TEM). dsDNA HS was used to test the plasmid release of PLGA/pFGF-2 scaffold. The viability and proliferation of hPDLCs on the two kinds of scaffolds were evaluated by the CCK-8 assay, and the expression of collagen I and scleraxis were analysed by RT-qPCR. The roots of avulsed teeth were covered by the two types of scaffolds and replanted into the alveolar pockets in beagles. Haematoxylin-eosin and Masson staining were used to evaluate the effects of PLGA/pFGF-2 scaffold on promoting PDL regeneration. RESULTS: The smooth and uniform fibres can be observed in both scaffolds, and the plasmids were randomly distributed in the PLGA/pFGF-2 scaffold. dsDNA HS analysis demonstrated that the PLGA/pFGF-2 scaffold released up to 123 ng pFGF-2 over 21 days in a sustained manner without any obvious burst release. The PLGA/pFGF-2 scaffold promoted the proliferation of hPDLCs and increased the expression levels of collagen I and scleraxis compared with PLGA scaffold. Animal experiments showed that more regular PDL-like tissues and less root surface resorption occurred in the PLGA/pFGF-2 scaffold group compared with the PLGA scaffold group. CONCLUSIONS: The PLGA/pFGF-2 scaffold promoted hPDLCs proliferation and facilitated periodontal ligament-related differentiation. The PLGA/pFGF-2 scaffold possesses excellent biological characteristics and could be used as a promising biomaterial for improving the treatment prognosis of replanted tooth.

Long-term Outcomes of Autotransplantation of Teeth: A Case Series.

The aim of autotransplantation of teeth (ATT) is to replace a lost tooth with a functional tooth within the same patient. Although it has recently become more of a recognized and viable treatment approach in dentistry, the long-term outcomes are still not well-documented. The principal author (M.T.) has performed more than 1000 ATTs for reasons such as treating missing teeth, deep caries, poor endodontic results, and periodontitis over the past 30 years in private practice. During the course of private practice, 2 separate analyses were performed on a total of 319 cases with follow-up ranging from 2-26 years. The results showed a tendency toward higher success rates in younger patients; the success rate was highest in ATTs performed on immature teeth (about 95%), about 90% in patients younger than 30 years of age and approximately 80% in patients older than 30. The failures were most often caused by replacement resorption (ie, ankylosis-related resorption). The purpose of this case series was to show successful long-term outcomes of ATT as well as to provide clinical insights and describe tendencies noted over the course of 30 years of performing ATTs.

Simulation of postoperative occlusion and direction in autotransplantation of teeth: application of computer-aided design and digital surgical templates.

Autotransplantation of teeth requires optimisation of both occlusion and direction to ensure minimal injury to the dental crown and the alveolar bone. We describe a method that could simulate postoperative occlusion and direction of the donor tooth by using CAD and digital surgical templates, and evaluate the postoperative effect in five patients who had teeth autotransplanted. Computed tomographic data were imported into ProPlan CMF 3.0 software, the donor tooth was simulated to replace the recipient site according to the position of the occlusion and alveolar bone, and a digital template was designed to guide preparation of the socket. A computer-aided, rapid prototyped, tooth was used to match the socket and, finally, an occlusal template was designed to ensure that the donor tooth was in the simulated position. We compared the position of the tooth in the simulation with its postoperative position using ProPlan CMF 3.0 software. In this way it was possible to simulate and guide the donor tooth accurately to the recipient site. At six-month follow up all teeth had survived successfully. Given the efficiency and precision of placement and the success, we conclude that CAD can successfully help to simulate occlusion and direction in autotransplantation of teeth while simplifying the procedure.

Long-term outcomes of autotransplantation of teeth: A case series.

The aim of autotransplantation of teeth (ATT) is to replace a lost tooth with a functional tooth within the same patient. Although it has recently become more of a recognized and viable treatment approach in dentistry, the long-term outcomes are still not well-documented. The principal author (MT) has performed more than 1000 ATTs for reasons such as treating missing teeth, deep caries, poor endodontic results, and periodontitis over the past 30 years in private practice. During the course of private practice, 2 separate analyses were performed on a total of 319 cases with follow-up ranging from 2 to 26 years. The results showed a tendency toward higher success rates in younger patients; the success rate was highest in ATTs performed on immature teeth (about 95%), about 90% in patients younger than 30 years of age and approximately 80% in patients older than 30. The failures were most often caused by replacement resorption (ie, ankylosis-related resorption). The purpose of this case series was to show successful long-term outcomes of ATT as well as to provide clinical insights and describe tendencies noted over the course of 30 years of performing ATTs.

Transplante dentário autógeno: revisão de literatura e relato de caso clínico / Autogenous dental transplantation: literature review and clinical case report

Objetivo: o transplante dentário é uma técnica cirúrgica que consiste na movimentação cirúrgica de um dente, podendo ser vital ou tratado endodonticamente, o qual é submetido a uma avulsão do seu local de origem e implantado em outro alvéolo. Relato de caso: paciente do sexo masculino, 18 anos, normossistêmico, buscou atendimento no Serviço de Cirurgia e Traumatologia Bucomaxilofacial da Pontífica Universidade Católica do Rio Grande do Sul (PUCRS) apresentando cárie no dente 26. O plano de tratamento consistiu em realizar um autotransplante do dente 28 para o alvéolo do dente 26. Após 8 meses do transplante, o dente apresentava em boas condições periodontais avaliadas clinicamente e em exame radiográfico. Considerações finais: o transplante dentário autógeno pode ser uma opção viável para a substituição de molares ausentes ou com cáries extensas, como mostrado no presente caso clínico. (AU)

Objective: Dental transplantation is a surgical technique that consists of the surgical movement of an either vital or endodontically treated tooth, which is subjected to an avulsion from its place of origin and implanted in another socket. Case report: An 18-year-old male patient, normosystemic, attended the Oral and Maxillofacial Traumatology Surgery Service of PUCRS presenting a decayed tooth 26. The treatment plan consisted of the autotransplantation of tooth 28 to the alveolus of tooth 26. Eight months after the transplantation, the tooth presented satisfactory periodontal conditions by clinical and radiographic assessments. Final considerations: The autogenous dental transplantation may be a viable option for replacing absent molars or with extensive caries, as shown in the present clinical case. (AU)

Outcomes of autotransplanted teeth and prognostic factors: a 10-year retrospective study.

OBJECTIVES: This retrospective study aimed to investigate the clinical outcome of tooth autotransplantation and related prognostic factors. MATERIALS AND METHODS: Eighty-two cases of transplanted teeth from March 2006 to December 2016 were retrospectively investigated by medical records and radiographs. The clinical outcomes of transplanted teeth, which included tooth survival, inflammatory root resorption (IRR), ankylosis, and marginal bone loss (MBL), and the related prognostic factors were assessed via survival analysis. RESULTS: The cumulative survival rate of transplanted teeth was 74% at 10 years after autotransplantation. According to Cox proportional hazards regression analysis, the eruption state of the donor tooth, recipient position, and postoperative MBL were significantly related to tooth survival. The donor tooth position was significantly associated with IRR, the recipient position and the timing of orthodontic initiation with ankylosis, and the recipient position with MBL. CONCLUSIONS: Fully erupted donor teeth and a bounded recipient site were significantly associated with longer tooth survival. Periodontal healing and management to prevent postoperative MBL were as important for successful autotransplantation. CLINICAL RELEVANCE: Knowledge about the prognostic factors that are significantly associated with each particular clinical outcome may guide clinicians to achieve predictable and successful outcomes after tooth transplantation.

[A retrospective clinical study on autotransplantation of teeth with complete root formation].

Objective: To evaluate the 5-year survival and success rates of transplanted autologous teeth with complete root formation. Methods: A total of 32 patients admitted to the hospital for 36 cases of tooth autotransplantation with complete root formation from November 2008 to October 2012 were enrolled in this study. Clinical and radiographic examinations were performed during the post-operative follow up periods of 1 month, 3 months, 6 months, 9 months and 12 months, respectively. Survival analysis was then conducted and the predictive factors influencing prognosis from the aspects of age, sex and root canal treatment status were investigated. Kaplan-Meier survival curve was adopted for survival analysis and Log-Rank test was used to compare the survival rate and success rate of each single factor. Results: According to each case's last follow-up, the 5-year survival rate of autotransplanted teeth with complete root formation was 83%. Within these cases, the 5-year success rate of the autotransplanted teeth with no apparent periodontitis or apical periodontitis, and the crown to root ratio being less than 1 was 65%. Factors of age and sex of the patients showed no correlation with the prognosis of autotransplantation (P>0.05). Root canal treatment was crucial in preventing transplanted teeth from apical periodontitis and root resorption, and accordingly increased the success rate (P=0.028) of autotransplantation. Conclusions: Autotransplantation with complete root formation has a high 5-year survival rate, and is a viable and alternative method for restoration of tooth loss. Post-operative follow-up should be thoroughly planned and root canal treatment should be performed in order to increase the survival rate and success rates of autotransplantation.

[An (un)conventional autogenous tooth transplantation]. / Een (on)conventionele autotransplantatie.

A 15-year-old boy was referred to an Oral and Maxillofacial Surgery department because of a persistent tooth 85 and a malposition of tooth 45. Following additional examination, it was concluded that the root formation of tooth 45 was already completed. Furthermore, it was horizontally impacted against the inferior border of the mandible. The decision was made to extract tooth 85 and to autotransplant tooth 45. Post-operatively, tooth 45 was fixed to the orthodontic equipment already in place and later treated endodontically. The success rate of this kind of autotransplantation of teeth with already closed apices (94%) is comparable in the literature to the success rate of autotransplantation of teeth with open apices (98%). Autotransplantation should be considered, especially in patients who are still growing and for whom dental implants do not (yet) offer a solution.