Anterior Tooth Autotransplantation
Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Traumatic tooth injuries, along with impacted and congenitally missing permanent teeth are relatively common in the anterior segment of the mouth. Autotransplantation of teeth into the anterior dental arch can provide unrivalled biological solutions when such issues arise in this critical aesthetic zone, particularly for adolescent patients.
Despite the undeniable physiologic and cost-benefit advantages of successful immature tooth autotransplantation, this technique remains under-utilised. A common misconception that a transplanted tooth routinely requires elective endodontic treatment still persists. Several previous publications with long-term follow-up have clearly demonstrated that the autotransplantation of immature teeth does not routinely require any form of endodontic treatment and has impressive survival rates (i.e. exceeding 80%).1,2,3
Historical skepticism regarding the autotransplantation procedure has emanated from the perception that it is overly technique sensitive. Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three-dimensional computed tomography and rapid prototyping (i.e for use as biomodels) have the potential to simultaneously reduce the technique sensitivity and increase the predictability of the autotransplantation procedure.
Successful tooth autotransplantation in growing patients provides ongoing root development, maintains alveolar bone and periodontal health, and does not preclude future orthodontic tooth movement. The phenomenal value of autotransplantation for growing patients requires due recognition and appreciation, as this procedure permits cost-effective dental recycling and ideal rehabilitation using the most biocompatible material available, the patient’s own natural tooth2.
We are running a really awesome course which will discuss this and show the technique of how to do it. It will be offered online and face-to-face.
References
1. Czochrowska EM, Stenvik A, Bjercke B, Zachrisson BU. Outcome of tooth transplantation: Survival and success rates 17-41 years post treatment. Am J Orthod Dentofac Orthop 2002; 121 (2):110–119.
2. L.A. Machado, R.R. do Nascimento, D.M.T.P. Ferreira, C.T. Mattos, O.V. Vilella: Long-term prognosis of tooth autotransplantation: a systematic review and meta-analysis. Int. J. Oral Maxillofac. Surg. 2016; 45:610–617.
3. Ong D, Itskovich Y, Dance G. Autotransplantation: a viable treatment option for adolescent patients with significantly compromised teeth. Aust Dent J. 2016 Dec;61(4):396-407.