Autogenous tooth transplantation for replacing a lost tooth: case reports
A 43 year old male visited the clinic complaining about the discomfort and pain in the upper right molar area while biting. The clinical and radiographic examination revealed that the maxillary right second premolar and the maxillary right first molar were both associated with localized severe chronic periodontitis. In contrast, the maxillary right second molar had healthy condition without an opposing tooth ( and ). Considering the financial difficulty of the patient, autotransplantation was preferred to implant installation. Following consultation with a periodontist, the maxillary right second molar was planned to be transplanted to maxillary right first molar space and periodontal treatment was planned after that.\nScaling and root planning was performed at 1 month before autotransplantation. Due to the trismus of the patient, root canal therapy was performed after the surgery. Surgical procedure was similar to that described for case 1. Under local anesthesia, the maxillary right first molar was extracted. The recipient site was prepared with a round bur and a duplicated tooth model. The maxillary right second molar was extracted and immediately placed into the recipient site. It was stabilized with 4-0 silk sutures and a semi-rigid resin wire splint (). The extra-oral time from extraction of the maxillary right second molar to transplantation was 11 minutes. Amoxicillin 500 mg three times a day and Ibuprofen 400 mg three times a day were prescribed for a week, and a 0.1% chlorhexidine rinse was used for 7 days.\nThe root canal therapy was begun 2 weeks later. After the calcium hydroxide dressing was maintained for 2 weeks, root canal therapy was completed at 4 weeks after the surgery.\nAt the 7 month follow up, there was no clinical symptom or radiographic signs of root resorption (). As planned, the regenerative periodontal surgery was done on the maxillary right second premolar which had deep periodontal pocket. A new bone formation around the bifurcation area of the transplanted tooth was confirmed during the surgery (). The autotransplanted tooth will be restored with a full crown. At the 18 month follow up, the transplanted tooth had a normal periodontal pocket depth and no mobility.