J Dent Rehabil Appl Sci.  2023 Mar;39(1):52-60. 10.14368/jdras.2023.39.1.52.

Replantation of autotransplanted mature third molar in anterior open bite patient: case report

• Kim HJ

• KMID: 2549252
• DOI: http://doi.org/10.14368/jdras.2023.39.1.52

Abstract

Autotransplantation of third molars with completely formed roots is known to be effective and provide a high long-term success rate. However, in case of severe mobility or unexpectedly extraction is observed during the monitoring period after surgery, it is generally considered as a failure. This case report describes successful replantation of autotransplanted mature third molar into surgically created molar socket. 1 year follow up of transplanted tooth showed clinically normal periodontal pocket depth and tooth mobility. Root resorption or bone loss were not observed. Provided that there is no apparent sign of inflammation, re-insertion into socket is a viable alternative to immediate determination of extraction.

Keyword

autotransplantation; open bite; replantation

Figure

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  Fig. 1 (A) Pre-operative panoramic view showing the presence of third molars for transplantation, (B) Radiograph showing a non-restorable mandibular first molar with extensive caries and an apical radiolucency with previously treated canals, (C) Extraction of #46.

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  Fig. 2 Vertical bone resorption at the extraction site. (A) The opposing maxillary first molar showing slight extrusion. Tongue thrusting in open bite occlusion is also noted, (B) Healed ridge two months after extraction, (C) Extraction of #18 as a donor tooth, (D) Postoperative radiograph after transplantation of the third molar into the socket of the non-restorable mandibular first molar, (E) Autotransplantation of the upper third molar to the mandibular first molar extraction site.

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  Fig. 3 Complete loss of stability of the transplant was observed after 20 days. (A) Radiograph after immediate re-insertion into the socket, (B) Previous opposing old crown (#16), (C) Maximum occlusal clearance was achieved with the temporary crown on the upper opposing maxillary first molar, (D) Fabrication of the new crown on #16.

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  Fig. 4 Radiographs after replantation of the transplanted tooth. (A) Splint removal was performed two weeks after replantation, (B) Provisional restoration in function for two weeks after splint removal. Note the regeneration of the mesial bone, (C) Final crown setting 3.5 months after autotransplantation, (D) One-year postoperative radiograph showing excellent results.

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  Fig. 5 Clinical view after one year. (A) A definite vertical stop was established only on #16. Shallow occlusion was seen on the buccal cusp of #15. Note that healthy attached gingiva was maintained, (B) Decreased size of occlusal table was designed for prevention of occlusal overload.

Reference

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