A retrospective analysis of factors influencing the success of autotransplanted posterior teeth

Clinical Assessment of Immediate Autotransplantation of Mandibular Third Molars: An In Vivo Study

INTRODUCTION

Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients' teeth with developing alveolar bone because it uses the patient's own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar.

MATERIALS AND METHODS

In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed.

RESULTS

Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption.

CONCLUSION

Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.

An evaluation of 1654 premolars transplanted in the posterior region-A retrospective analysis of survival, success and complications

AIM

The aim of this retrospective analysis was to evaluate the survival, success and possible complications of transplanted premolars in the posterior region subdivided by developmental stage and patient age.

MATERIALS AND METHODS

This study included patients who underwent tooth transplantation between April 2004 and December 2021. A total of 1654 premolars were transplanted into 1243 patients. Tooth mobility, oral hygiene and periodontal parameters were clinically evaluated. Intraoral radiographs were used to evaluate pulpal and periodontal healing, and root formation. The cumulative survival rate was calculated using the Kaplan-Meier method.

RESULTS

Data were subdivided into three groups based on the stage of root development and patient age. The mean age at surgery was 14.5 years. The main indication for transplantation was agenesis, followed by trauma and other indications, such as impacted or malformed teeth. A total of 11 premolars were lost during the study period. The overall survival and success rates in the immature premolar group after an observation period of 10 years were 99.7% and 99.4%, respectively. High survival and success rates (95.7% and 95.5%, respectively) were also observed when fully developed premolars were transplanted into the posterior region of adolescents. In adults, the success rate after 10-year follow-up is 83.3%.

CONCLUSIONS

Transplantation of premolars with developing and fully developed roots is a predictable treatment modality.

Should we predict poor prognosis in autotransplantation of teeth with completed root formation?

Dental autotransplantation is a dental treatment whereupon a natural donor tooth from the same person replaces a missing tooth at the recipient site. This treatment modality has been ignored by many clinicians for decades. This paper discusses the “poor” prognosis of autotransplantation of teeth with complete root formation as described in a recent publication. It delivers a straightforward message indicating that success and failure are multifactorial.

Three-Dimensional (3D) Stereolithographic Tooth Replicas Accuracy Evaluation: In Vitro Pilot Study for Dental Auto-Transplant Surgical Procedures

After immediate tooth extraction or after alveolar socket healing, tooth transplants are increasingly used for functional restoration of edentulous maxillary areas. Recent studies have shown the periodontal ligament (PDL) viability and the tooth housing time in the adapted neo-alveolus as key factors for transplantation success. During surgical time, 3D stereolithographic replicas are used for fitting test procedures. In this paper, the accuracy of 3D dental replicas, compared with the corresponding natural teeth, is assessed in surgical transplantation. Lamb skulls were selected and submitted to Cone Beam Computer Tomography (CBCT). Scanning information, converted into Standard Digital Imaging and Communications in Medicine (DICOM) and Standard Triangulation Language (STL), was sent to the Volux X-ray Centre for 3D replica printing. After the tooth extractions, all lambs’ incisors were measured with a digital caliber and compared with the 3D replicas. Volume and dimensional error values were evaluated. All replicas showed macroscopically smaller volume (45.54%). Root replicas showed higher variations compared with the crown areas, with several unreplicated apical root areas. The cement–enamel junction tooth area was replicated quite faithfully, and the base area relative error showed 9.8% mean value. Even further studies with a larger number of replicas are needed. Data obtained confirmed high volumes of macroscopic discrepancies with several unreproduced apical root sites. The achieved accuracy (90.2%) confirmed that the 3D replicas cannot be used to reduce the surgical time during transplantation predictable procedures.

Application effect of computer-aided design combined with three-dimensional printing technology in autologous tooth transplantation: a retrospective cohort study

BACKGROUND

The activity of donor periodontal membrane is the key factor of autologous tooth healing. The application of digital aided design, 3D printing model and guide plate in autotransplantation of tooth (ATT) is expected to reduce the damage of periodontal membrane and preserve the activity of periodontal membrane, so as to improve the success rate of ATT. This study tried to prove the role of digital technology in improving the success rate of ATT, although there are differences in model accuracy in practice.

METHODS

We included 41 tooth autotransplantation cases which assisted by 3D-printed donor models and surgical guides and divided them into two groups in accordance with whether the donor tooth could be placed successfully after the preparation of alveolar socket guided by the model tooth. Then, we compared and analyzed the preparation time of alveolar socket, extra-alveolar time, and number of positioning trials of the donor tooth between the two groups. We also included a comparison of the in vitro time of the donor tooth with that of 15 min. The incidence of complications was included in the prognostic evaluation.

RESULTS

The mean preparation time of the alveolar socket, mean extra-alveolar time of donor tooth, and mean number of positioning trials with donor tooth of 41 cases were 12.73 ± 6.18 min, 5.56 ± 3.11 min, and 2.61 ± 1.00, respectively. The group wherein the donor tooth cannot be placed successfully (15.57 ± 6.14 min, 7.29 ± 2.57 min) spent more preparation time of alveolar socket and extra-alveolar time than the group wherein the donor tooth can be placed successfully (9.75 ± 4.73 min, 3.75 ± 2.57 min). The number of positioning trials with the donor tooth of the group wherein the donor tooth cannot be placed successfully (3.19 ± 0.75) was higher than that of the other group (2.00 ± 0.86). There was no significant difference in survival rates between the two groups.

CONCLUSIONS

Compared with the traditional tooth autotransplantation, the introduction of computer-aided design combined with 3D printing of the model tooth and surgical guides evidently shortens the preparation time of the alveolar socket and the extra-alveolar time of the donor tooth and reduces the number of positioning trials with the donor tooth regardless of the shape deviation between the model and actual teeth.

Survival of Autotransplanted Teeth With Open Apices: A Retrospective Cohort Study

PURPOSE

Autotransplantation of teeth is an alternative treatment method in growing patients with hypodontia or impacted teeth. The purpose of the present study was to investigate the occurrence of, and predictors for, the loss of transplanted teeth in children and young adults.

PATIENTS AND METHODS

All patients who had undergone tooth transplantation at the Department of Oral and Maxillofacial Surgery, Turku University Hospital, from October 1, 2009 to January 5, 2017, were identified from the hospital's database. The outcome variable was survival of the transplanted tooth. The predictor variables were the transplantation type, donor tooth, maturity of the donor tooth, number of roots of the donor tooth, recipient's jaw, the need for extraoral storage of the donor tooth during surgery, continuation of root development during follow-up, and institution experience. One tooth was randomly selected from each subject. The Kaplan-Meier method for survival analysis, and the Cox proportional hazards regression analysis results were used to assess the association between survival and the risk factors.

RESULTS

The sample included 36 subjects with a mean age of 14.3 years; 33.3% were male, 45 teeth were transplanted, and the median follow-up time was 1.3 years. The 1-year survival rate was 87% (95% confidence interval [CI], 75 to 99%). A significant predictor for tooth survival was the continuation of root development (hazard ratio, 21.3; 95% CI, 2.1 to 215.0; P = .009). Although not statistically significantly, more favorable prognoses were found for distant than for transalveolar transplantations, 1-rooted than multirooted teeth, premolars than molars, teeth not stored in an extraoral media, and teeth that had been transplanted later during the study period.

CONCLUSIONS

The experience of the professional team, use of open apex premolars, and postoperative continuation of root development of the transplant were the factors associated with favorable outcomes. Transplants could benefit from the use of 3-dimensional models during surgery.

Autotransplantation of mature impacted tooth to a fresh molar socket using a 3D replica and guided bone regeneration: two years retrospective case series

Background

The aim of this study was to evaluate the clinical outcome of autotransplantation of mature third molars to fresh molar extraction sockets using 3D replicas.

Methods

Ten patients underwent teeth autotransplantation with or without GBR. We observed the mobility, percussion, radiography examination, the probing depth and the masticatory function of the transplanted teeth during 2 years following up, which were transplanted into fresh molar sockets by using 3D replicas, and GBR when it is necessary.

Results

The average extra-oral time of donor tooth had been shortened to 1.65 min when used the 3D replica. Some probing depth of the transplanted tooth were deeper than 3 mm at 4 or 5 weeks temporarily. And one patient felt slight sensitive when chewing with soft food at 4 weeks, then disappeared. The clinical examination of the autotransplantation teeth during 1 year follow-up showed no sign of failure.

Conclusions

The tooth autotransplantation using 3D replica with or without GBR is an effective method which can reduce the extra-oral time of the donor teeth and may result in less failure.