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HTTP WWW - Styleitaliano.org Autotransplantation of Third Molar
HTTP WWW - Styleitaliano.org Autotransplantation of Third Molar
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The first permanent molars are very prone to caries because of their anatomical structure, with deep
pits and fissures, and early eruption in the mouth. They sometimes need to be restored very early,
and the standard of care is often sub-optimal. So, in adolescence, it may happen that they become
cronically infected and non-restorable. Extraction is mandatory in these cases, but the patient is often
too young for an implant or a three-unit FDP. Waiting means mesial migration of second and third
molars, and perhaps extrusion of maxillary molars. Even worst, space maintainers have an high failure
rate.
In these cases, tooth auto-transplantation can be an option, when a donor tooth is available.
Here is a protocol for wisdom tooth transplantation:
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Adam Zawadka
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Walter Devoto
Dr. Walter Devoto Born in
Chiavari on 29/03/1965
graduated in Dentistry in 1991
at Genova University.
Angelo Putignano
M.D. degree and D.D.S. post
graduate certificate from
University of Ancona-Italy.
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The first case refers to a 16 y/o patient with a non-restorable first mandibular molar, the second to a
45 y/o patient with vertical root fracture of first maxillary molar.
In the second case, pulp asportation was followed by histology. The pulpal tissue was substituted
by a dense fibrous tissue, without necrotic areas.
The literature reports excellent success rates following tooth transplantation when the appropriate
protocol is followed. Andreasen found 95% and 98% long-term survival rates for incomplete and
complete root formation of 370 transplanted premolars observed over 13 years.
Jens O. Andreasen, Atlas of Replantation and Transplantation of Teeth, W.B. Saunders, 1992; Tatjana
Nim?enko, Gravydas Omerca, Vaidas Varinauskas, Ennio Bramanti, Fabrizio Signorino, and Marco
Cicci Tooth auto-transplantation as an alternative treatment option: A literature review Dent Res J
(Isfahan). 2013 Jan-Feb; 10(1): 16.
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