Restor Dent Endod.  2015 Aug;40(3):236-240. 10.5395/rde.2015.40.3.236.

Autotransplantation combined with orthodontic treatment: a case involving the maxillary central incisors with root resorption after traumatic injury

• Ferreira M
• Ferreira H
• Botelho F
• Carrilho E

• KMID: 2396468
• DOI: http://doi.org/10.5395/rde.2015.40.3.236

Abstract

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.

Keyword

Autotransplantation; Orthodontic treatment; Surgical procedure

MeSH Terms

Ankylosis
Autografts*
Bicuspid
Dental Pulp Cavity
Esthetics
Follow-Up Studies
Humans
Incisor*
Necrosis
Replantation
Root Resorption*
Tissue Donors
Tooth
Tooth Extraction

Figure

• 

  Figure 1 (a) Intraoral image showing an anterior open bite; (b) Radiograph of tooth 21 with root resorption and measures used to prepare the socket to receive the tooth to be transplanted; (c) Radiograph of teeth 11 and 12 with root resorption and measures used to prepare the socket to receive the tooth to be transplanted.

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  Figure 2 (a) A donor tooth placed into an artificial socket, stabilized with 3-0 silk sutures crossing the occlusal face of the tooth, and fixed with composite. An artificial alveolus was prepared according to predetermined dimensions for the tooth chosen for transplantation 10 days later; (b) Tooth transplanted 10 days after the socket had been prepared.

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  Figure 3 (a - c) Orthodontic movement of the teeth initiated three months after transplantation; (d) A follow-up radiograph obtained four months after transplantation.

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  Figure 4 A transplanted tooth after root canal treatment, showing good periodontal healing.

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  Figure 5 The treatment was determined to be aesthetically and functionally successful after seven years of post-transplantation follow-up.

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