Autogenous tooth transplantation for replacing a lost tooth: case reports
A 28 year old male visited the Department of Conservative Dentistry at Chonnam National University Dental Hospital for treatment of mandibular left second molar. The patient complained no clinical symptoms and had a normal periodontal pocket depth. However, the clinical and radiographic examination revealed that the mandibular left second molar was severely decayed. A single implant installation after extraction was one of the treatment options. However, considering the opinion of the patient and other oral environments, autotransplantation of maxillary right third molar was decided (, ).\nA duplicated tooth model was fabricated with resin using computerized tomography (CT) image of the maxillary right third molar. Cone-bean CT scans of maxillary right third molar had been acquired using Mercuray (Hitachi, Tokyo, Japan) with 120 kV and 150 mAs. Under local anesthesia using 2% lidocaine with 1:100,000 epinephrine, the carious mandibular left second molar was extracted. The duplicated tooth model fitting the recipient site was used. The recipient site was prepared with a round bur under copious sterile saline irrigation. The maxillary right third molar was then carefully extracted with forceps. Root end resection and retrograde filling with ProRoot MTA (MTA, Dentsply Tulsa, Tulsa, OK, USA) was performed on the donor tooth to prevent endodontic complications. After fitting of the maxillary right third molar into the prepared 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 third molar to transplantation was 10 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.\nStich-out was done after 1 week. The root canal therapy was started at 4 weeks. After the calcium hydroxide dressing was maintained for 2 weeks, root canal therapy completed with thermoplasticized gutta-percha and AH Plus sealer (Dentsply De Trey GmbH, Konstanz, Germany) at 6 weeks (). All endodontic procedures were carried out under a rubber dam and a strict aseptic condition. At the 6 month follow up, the transplanted tooth was asymptomatic and periodontally healthy. In addition, new bone formation on the mesial side of the tooth was observed and periodontal pocket depth is normal. After confirming such condition, the tooth was restored with a full crown ().