Autogenous tooth transplantation as a treatment option

Interventive dental therapy in Ancient Egypt (ca. 2686 BCE - AD 323): A critical review

OBJECTIVE

This paper critically reviews the history of research concerning ancient Egyptian interventive dental therapy between the Old Kingdom - Graeco-Roman Period (c. 2686 BCE-AD 323), concentrating on the published osteological evidence.

MATERIALS

Eight osteological examples reportedly exhibiting markers of interventive dental therapy, including a mandible presenting purported evidence for a drilling procedure for the relief of an abscess; four dental bridges; a maxilla with multiple teeth extracted; and two carious lesion fillings.

METHODS

Previous claims are critically reviewed using a qualitative research method involving collecting and critiquing published data, both primary evidence and relevant secondary literature.

CONCLUSIONS

Without further scientific analysis, only four specimens can currently be plausibly attributed to ancient Egyptian interventive dental therapy including the Tura el-Asmant Bridge, the enucleation described for a Graeco-Roman child, and two carious lesion fillings identified in the mummified individuals known as the 'Redpath Mummy' (RM2718) and 'Sekhem' (AIG3343).

SIGNIFICANCE

Several enduring historiographical and museological problems within the discourse are identified, revising our understanding of the nature and scope of ancient Egyptian interventive dental therapy based on currently known osteological evidence.

LIMITATIONS

This review relies on the published documentation for each osteological example, namely images, which in several cases are poor quality.

SUGGESTIONS FOR FURTHER RESEARCH

There is significant opportunity for further scientific analysis of the osteological evidence discussed. In each case, specific potential methods to improve our understanding and interpretation have been identified.

Pre- and peri-operative factors influence autogenous tooth transplantation healing in insufficient bone sites

Background

The amount of bone remaining at the transplant site for autogenous tooth transplantation can facilitate successful healing. Therefore, this retrospective study evaluated the factors influencing the healing of 50 successful autogenous tooth transplantations with insufficient bone support at the transplanted site without a bone graft.

Methods

The factors were classified as pre- and peri-operative factors, and the healing outcomes were clinical and radiographic observations. The factors were statistically analyzed using the chi-square test to identify correlations between the pre- and peri-operative factors and the clinical and radiographic outcomes. The T-test or one-way analysis of variance was used to compare the percent bone change in each factor.

Results

The results indicated that gingival healing was delayed in the intra-arch transplantations, and pulp obliteration was seen earlier when transplanted in the maxilla. Patients under 18-years-old demonstrated a greater percent bone change than the over 18-year-old patients, while the peri-operative variables did not have a relationship with clinical healing and the amount of bone change over 12 months. Furthermore, the percent bone change significantly increased during the first three months.

Conclusions

In conclusion, pre-operative factors, age and transplant site, influenced the healing rate of autogenous transplanted teeth. In contrast, the peri-operative factors were not related with the clinical and radiographic outcomes. Generating the least trauma to the periodontal ligament cells is the most important concern.

Retrospective Evaluation of Immediate Impacted Third Molars Autotransplantation After Extractions of Mandibular First and/or Second Molars With Chronic Periapical Lesions

PURPOSE

To evaluate the success rate of simultaneous autotransplantation of the immature impacted third molars with the guidance of computer-aided rapid prototyping (CARP) to the place of mandibular first or second molars with extraction indication due to the untreatable radiographic periapical lesions.

PATIENTS AND METHODS

Twelve radiographically and clinically hopeless mandibular first or second molars with periapical lesions of 10 patients between the ages of 15 to 21 were included in this retrospective clinical study. Cone-beam computed tomography (CBCT) images were used to produce the CARP models of the donor impacted third molars. Following the extractions of the mandibular first or second molars with periapical lesions, sockets were curetted and prepared with proper burs until a suitable infraocclusal fit of the CARP models. The donor teeth were transplanted synchronously with their surgical extractions. Postoperatively patients were followed clinically and radiographically in the 3rd and 6th months and every 6th month thereafter for at least 18 months. Clinically, the mobility, periodontal plaque, bleeding on probing, percussion sensitivity, periodontal pocket, vitality, and occlusion, and radiographically, the root resorption, ankylosis, presence of lamina dura, and healing of periapical lesion were assessed.

RESULT

By the end of 12th month, and thereafter, all transplanted teeth were in occlusion and functioning properly with no clinical or radiological signs of pathology. All of the autotransplantation cases involved in this clinical study were successful within a mean follow-up period of 20.4 months with the least one of 18 months.

CONCLUSION

Immediate autotransplantation of the immature third molars to the place of mandibular first or second molars with extraction indication due to the periapical lesion can be a proper treatment option for adolescent patients.

Alternative treatment plan for congenitally missing teeth in an adolescent patient: A case report

BACKGROUND AND OVERVIEW

Mandibular second premolars are the second most commonly missing teeth, and there are various treatment alternatives to restore the space of the missing teeth. However, in growing patients, implants are contraindicated because they prevent growth of bone.

CASE DESCRIPTION

In this case report, the authors describe a 13-year-old girl with Class II malocclusion with congenitally missing mandibular second premolars. Autotransplantation of 2 maxillary premolars to the missing teeth site was performed considering the presence of crowding in the maxillary anterior segment. The teeth were fixed with a semirigid splint for 3 months. The patient had an acceptable occlusion at the end of the orthodontic treatment, which lasted 20 months.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The autotransplanted right premolar showed normal physiological adaptation, whereas the tooth on the left side was ankylosed. The short-term results show that autotransplantation, which requires high technical sensitivity, may provide a biological and economical alternative to tooth replacement.