Endodontic considerations of survival rate for autotransplanted third molars: a nationwide population‐based study

Abstract

AimTo investigate whether the timing of root canal treatment (primary aim) or other endodontic parameters (secondary aim) is associated with the survival probability of autotransplanted third molars, using a nationwide population‐based database.MethodologyA total of 1811 third molars autotransplanted between 2000 and 2013 met the inclusion criteria and were followed until the end of 2016. The teeth were classified into three groups on the basis of timing between root canal treatment and the autotransplantation: preoperative, extraoral and postoperative treatment groups. Univariate and multivariate Cox proportional hazards models were used to estimate the association between the timing of root canal treatment and the risk of tooth extraction after autotransplantation.ResultsOf the 1811 autotransplanted third molars, 462 were extracted, yielding a 17‐year survival probability of 0.578. The survival probability of autotransplanted teeth that received postoperative root fillings after 17 years was 0.583, which was significantly higher than the 0.434 and 0.566 for teeth that received preoperative and extraoral root fillings, respectively (P = 0.0013). After adjustment for potential confounding factors, teeth that received postoperative root fillings were associated with a significantly lower tooth extraction hazard ratio (HR) compared with those that received extraoral root fillings (adjusted HR, 1.43; 95% confidence interval [CI], 1.14–1.78) and those that received preoperative root fillings (adjusted HR, 2.13; 95% CI, 1.19–3.82). Furthermore, the use of a rubber dam during postoperative root filling was associated with a significantly lower extraction rate after autotransplantation (adjusted HR, 0.54; 95% CI, 0.43–0.69).ConclusionsPostoperative root canal treatment resulted in a significantly lower extraction rate than did preoperative or extraoral root canal treatment amongst autotransplanted third molars during a mean follow‐up period of 8.33 years. Rubber dam use is recommended during postoperative root canal treatment to improve the outcomes of autotransplantation.

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

“… Quaternary outcome: Motegi et al 2009 [ 39 ], Bauss et al 2005 [ 40 ], and Gault and Warocquier-Clerout 2002 [ 41 ]. Quinary outcome: Dharmani et al 2016 [ 42 ], Boschini et al 2020 [ 43 ], Lin et al 2020 [ 44 ], Mejàre et al 2004 [ 45 ], and Kumar et al 2013 [ 46 ]. …”

“…Quinary outcome: Dharmani et al 2016 [ 42 ], Boschini et al 2020 [ 43 ], Lin et al 2020 [ 44 ], Mejàre et al 2004 [ 45 ], and Kumar et al 2013 [ 46 ].…”

“…There is a risk of damaging the fibers and cells of the periodontal ligament when performing extraoral endodontic treatment [ 10 ]. A recent study conducted by Lin et al 2020 on 1811 autotransplanted third molars found a higher survival rate for teeth whose endodontic treatment was performed after the transplant, compared to extra-oral or preoperative endodontic treatment [ 44 ].…”

Immediate Tooth Autotransplantation with Root Canal Filling and Partially Demineralized Dentin/Cementum Matrix into Congenital Missing Tooth Region

“…The preservation of periodontal ligament cells is considered to be critical for the success of a transplanted tooth [ 4 , 5 , 6 ]. However, the timing of root canal treatments for donor tooth with complete roots has not been sufficiently discussed, nor well-documented [ 7 , 9 , 14 , 15 ]. Generally, in Japan, the extracted donor tooth is wrapped with wet gauze with normal saline solution during surgical procedures, transplanted into a socket, and then root canal treatments are started about 3–4 weeks later [ 7 ].…”

“…In India, root canal treatments were performed extra-orally for a mandibular third molar, and the transplanted tooth resulted in a satisfactory outcome [ 9 ]. In Taiwan, a postoperative root canal treatment resulted in a significantly lower extraction rate than preoperative or extraoral one, by using a nationwide population-based database [ 14 ]. The use of a rubber dam was recommended during postoperative root canal treatments, to improve the outcomes [ 14 ].…”