Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review

Abstract

Introduction: Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success. Materials and methods: This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases—PubMed, Scopus and Google Scholar—by two independent reviewers following the PRISMA protocol, from which 599 records were identified. Conclusions: Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root.

Autotransplantation of the Lower Posterior Teeth: A Comprehensive Review

“…Adequate bony support may not be present in some cases due to various reasons such as tooth aplasia or its early loss. Alveolar ridge resorption and root protrusion through dehiscence may occur in cases of insufficient bony support, so the use of free bone autografts in these cases is highly recommended [4].…”

“…The donor tooth should be atraumatically extracted to preserve and minimize the damage to the periodontal ligaments around the tooth [1,4], as one of the most important factors that affect the success of a transplanted tooth is the viability of periodontal ligaments [4,5,34]; these contain cells that have the potential to differentiate into cementoblasts, osteoblasts, and fibroblasts, and they have an important role in tissue regeneration [4]. Several studies have indicated that donor teeth with atrophic periodontal ligaments can be easily damaged and have a higher risk of complications [15,28,34].…”

“…Reducing the extraoral time of the donor tooth is an important factor to reduce periodontal ligament damage [10]. Increasing the time interval between the extraction and transplantation of the tooth will reduce the prognosis of the procedure [4]. The use of a 3D replica is recommended to reduce this time interval and decrease the number of attempts to position the donor tooth in the recipient site, which will reduce periodontal ligament damage [4,10].…”

“…Increasing the time interval between the extraction and transplantation of the tooth will reduce the prognosis of the procedure [4]. The use of a 3D replica is recommended to reduce this time interval and decrease the number of attempts to position the donor tooth in the recipient site, which will reduce periodontal ligament damage [4,10]. The 3D replica can be used as a guide for preparing the recipient site until it is perfectly fitted; then, extraction of the donor tooth can be done.…”

“…Tooth autotransplantation is considered a valuable treatment option as an alternative to extraction without replacement, implant-supported crowns, or other treatment options [1,2]. Tooth autotransplantation can be defined as the preplanned repositioning of a certain non-erupted, partially erupted, or fully erupted tooth that is done within the same patient [3][4][5]. Tooth transplantation through autogenous methods has long been used to replace missing teeth.…”