| INTRODUC TI ONAutotransplantation of teeth (ATT) has been performed for centuries, but its popularity has varied over the years because of unpredictable results. 1-9 However, with recent advancements in technology and better biological understanding, ATT has become more predictable.Yet, many clinicians are still not confident about this technique, in part because of the lack of studies on the long-term outcomes of these cases.The principal author (MT) has performed more than 1000 ATTs since 1987 in general private practice. Almost all of the cases were carefully recorded with photographs and radiographs in a standardized manner, and many were followed long-term. Here, the authors provide a case series showing long-term successful outcomes of ATT and general observations and tendencies noted throughout 30 years of performing ATTs in private practice.
| C A S E 1The patient was a 16-year-old female at the initial examination. Her chief complaint was with the mandibular right second premolar, which erupted ectopically on the lingual aspect ( Figure 1A). Extraction of the tooth was indicated, but a congenitally missing tooth (the mandibular left second premolar) was observed on the contralateral side, which had been restored with a fixed bridge ( Figure 1B). The root development of the mandibular right second premolar was around stage 4, which is considered an ideal stage as a donor tooth for ATT.After discussion of the risks, benefits, and options, transplantation of the premolar into the aplasia site was performed.After anesthesia of the donor and recipient sites, the bridge was sectioned, and the approximate recipient socket was formed. The donor tooth was extracted ( Figure 1C) and tried in the socket. This case was performed 25 years ago, and the techniques used then have
AbstractThe 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.
K E Y W O R D Sautotransplantation of teeth, pulp revascularization, reattachment,...