AUTOTRANSPLANTE DENTARIO

Dr. Máximo Hernández

La capacidad de regenerar esta presente en
los seres vivos

• Salamandra:

• Ser humano:
Todos los huesos re-
generan cada 10 años.
La piel cada 2 semanas y las
mucosas en 20 días .
Transplantes dentarios ?

IMPOSIBLE…..!
 Autotransplante Dentario

Es el transplante de un diente incluido,

impactado o erupcionado desde un sitio a otro
post extracción o quirúrgicamente preparado en
la misma persona.

Tanaka T. y cols. 2008

 Concepto

“ Debemos pensar que

estamos transplantando
células ”
Jens Andreassen
 Desarrollo de la Técnica
John Hunter (1772), inicia experimentación y
reporta éxito en alotransplante realizado a
hombre londinense.

Imagen 2: Transplanting of teeth, by Thomas

Rowlandson, 1787.
Imagen 1: Andreasen J.O., Reimplantación y
trasplante en odontología atlas. Suiza. 1992.
 Desarrollo de la Técnica

Andreasen y cols (1990),

publican el primer estudio que
muestra una tasa de éxito de
95% para dientes inmaduros
utilizando técnica quirúrgica
estandarizada.

Imagen 3. Andreasen y cols. (1990) A long term

study of 370 autotransplanted premolar.
 Appropriate patient selection was found to be a
key factor in the success of the technique

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• 1. Br Dent J. 2020 Feb;228(4):247-251. doi: 10.1038/s41415-020-1264-9.

Autotransplantation of third molars: a literature review and preliminary protocols.

Armstrong L(1), O'Reilly C(2), Ahmed B(3).

Author information: (1)DCT in Paediatric Dentistry, Birmingham Children's Hospital, UK. lucia.armstrong@nhs.net. (2)ACF in Paediatric Dentistry,
Birmingham Dental Hospital and School of Dentistry, UK. claire.o'reilly1@nhs.net. (3)Specialist in Oral Surgery, Birmingham Dental Hospital and
School of Dentistry, UK.

Tooth autotransplantation (the movement of a tooth from one site to another in the same person) is a technique with a history dating back many
centuries. However, the use of third molars as donor teeth is perhaps less well-recognised and less documented. A review of the current literature was
undertaken with particular attention to the use of the third molar as the donor tooth. The selection process, surgical procedure and follow-up pathways
were summarised in the review. Appropriate patient selection was found to be a key factor in the success of the technique. Other prognostic factors
were also discussed. The findings from the available literature suggest that autotransplantation is a viable and cost-effective technique. However, the
literature relating to the use of third molars as donor teeth for autotransplantation is limited and there are currently no evidence-based guidelines or
protocols relating to the technique. This paper discusses the literature and protocols the authors implement for autotransplantation of wisdom teeth.

DOI: 10.1038/s41415-020-1264-9 PMID: 32112013 [Indexed for MEDLINE]

 Protocolo quirúrgico atraumático
• Anestesia local.
• Extraer diente a reemplazar.
• Preparación del alvéolo receptor.
• Extraer el transplante atraumáticamente.
• Ubicar el transplante dentro de los confines del
alveolo.
• Realizar sutura ferulizadora.
• Administración de antibióticos.
Andreasen J.O., Reimplantación y trasplante en odontología atlas.
Suiza. 1992. p. 173
 Clinical application of 3D technology for tooth
autotransplantation: A case report

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Medicine (NLM). Do not reply directly to this message
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• 1. Aust Endod J. 2019 Apr;45(1):122-128. doi: 10.1111/aej.12260. Epub 2018 Feb 16.

Clinical application of 3D technology for tooth autotransplantation: A case report.

Kim K(1), Choi HS(1), Pang NS(1).

Author information: (1)Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.

This report presents two cases of tooth autotransplantation using cone-beam computed tomography (CBCT), the three-dimensional (3D)
simulation dental planning software and a computer-aided rapid prototyping (CARP) model. Two hopeless teeth of adult patients were
replaced as their third molar teeth. Before deciding the autotransplantation, diagnostic CBCT images were acquired and imported to
SimPlant software. The SimPlant dental program was used for surgical simulation prior to autotransplantation, which created 3D images
of the available donor teeth and recipient site tooth and superimposed the images to display their morphological similarity. Efficient
modification of the recipient socket was designed preoperatively. The CARP model of the donor tooth was prepared as a substitute for
the donor tooth that would be fit into the new recipient socket during bone preparation. Autotransplantation was favourably performed
in 5-6 min. Transplanted teeth healed up without clinical abnormality. The postoperative follow-up time was up to 6 years.

© 2018 Australian Society of Endodontology Inc.

DOI: 10.1111/aej.12260 PMID: 29450945 [Indexed for MEDLINE]

Retrospective study of 100 autotransplanted teeth with complete root formation and subsequent orthodontic treatment Satoshi
Kokai,aZuisei Kanno,bSarina Koike,cShunsuke Uesugi,dYuzo Takahashi,eTakashi Ono,fand Kunimichi Soma
Am J Orthod Dentofacial Orthop 2015;148:982-9
Retrospective study of 100 autotransplanted teeth with complete root formation and subsequent orthodontic treatment Satoshi
Kokai,aZuisei Kanno,bSarina Koike,cShunsuke Uesugi,dYuzo Takahashi,eTakashi Ono,fand Kunimichi Soma
Am J Orthod Dentofacial Orthop 2015;148:982-9
 Indicaciones
Pacientes sin historial médico
relevante.
Pérdida de
dientes
Reemplazo de
anteriores Reposicionamiento
primeros
maxilares Hipodoncia de dientes
molares
debido a ectópicos.
perdidos.
trauma o
patología.

Cross D. y cols.2012. Review. Develompments

in autotransplantation of teeth
 .
Autotransplantation of teeth in humans: a systematic review
and meta-analysis
• 1. Clin Oral Investig. 2015 Jul;19(6):1157-79. doi: 10.1007/s00784-015-1473-9. Epub 2015 Apr 24.

Autotransplantation of teeth in humans: a systematic review and meta-analysis.

Almpani K(1), Papageorgiou SN, Papadopoulos MA.

Author information: (1)Aristotle University of Thessaloniki, Thessaloniki, Greece.

OBJECTIVES: The aim of this investigation was to assess the currently available evidence concerning the complications
and risk factors influencing the outcome of autotransplantation of teeth in humans. MATERIALS AND METHODS:
Electronic searches were conducted to identify randomized controlled and prospective clinical trials. Risk of bias within
studies was assessed with the Downs and Black tool. Random-effects meta-analyses were conducted to pool the adverse
event rates and relative risks with their 95% confidence intervals. Risk of bias across studies was assessed with the
GRADE framework followed by sensitivity analyses. RESULTS: Thirty-eight studies were included in the analysis.
Reported complications included the need for extraction, failure, hypermobility, pulp necrosis, pulp obliteration, and root
resorption. Pooled complication event rates varied considerably, with small studies (<100 teeth) reporting greater
complication rates. The analysis of risk factors was associated with both the primary outcome (extraction need) and
secondary outcomes (failure, hypermobility, pulp necrosis, pulp obliteration, root resorption). The stage of root
development seems to influence both the future survival, as well as the success of the transplanted teeth . Teeth with open
apex were less likely to be extracted in comparison to teeth with closed apex (3 studies; 413 teeth; relative risk 0.3; 95%
confidence interval 0.2-0.6). CONCLUSIONS: Due to the small number of the contributing studies, their methodological
limitations, and the heterogeneous results reported, no firm conclusions can be drawn. CLINICAL RELEVANCE: Root
development of the donor teeth has been established as one the most important factor related to the success of tooth
autotransplantation.
 .Long-term Outcomes of Autotransplantation of Teeth: A
Case Series
• 1. J Endod. 2019 Dec;45(12S):S72-S83. doi: 10.1016/j.joen.2019.05.016. Epub 2019 Oct 14.

Long-term Outcomes of Autotransplantation of Teeth: A Case Series.

Tsukiboshi M(1), Yamauchi N(2), Tsukiboshi Y(3).

Author information: (1)Private Practice, Aichi, Japan. Electronic address: moonstar@guitar.ocn.ne.jp. (2)Private
Practice, Honolulu, Hawaii. (3)Private Practice, Aichi, Japan.

The aim of autotransplantation of teeth (ATT) is to replace a lost tooth with a functional tooth within the same patient.
Although it has recently become more of a recognized and viable treatment approach in dentistry, the long-term
outcomes are still not well-documented. The principal author (M.T.) has performed more than 1000 ATTs for reasons
such as treating missing teeth, deep caries, poor endodontic results, and periodontitis over the past 30 years in private
practice. During the course of private practice, 2 separate analyses were performed on a total of 319 cases with
follow-up ranging from 2-26 years. The results showed a tendency toward higher success rates in younger patients;
the success rate was highest in ATTs performed on immature teeth (about 95%), about 90% in patients younger than
30 years of age and approximately 80% in patients older than 30. The failures were most often caused by replacement
resorption (ie, ankylosis-related resorption). The purpose of this case series was to show successful long-term
outcomes of ATT as well as to provide clinical insights and describe tendencies noted over the course of 30 years of
performing ATTs.

Copyright © 2019 John Wiley & Sons A/S and American Association of Endodontists. Published by Elsevier Inc. All
rights reserved.

DOI: 10.1016/j.joen.2019.05.016 PMID: 31623912 [Indexed for MEDLINE]

 Autotrasplante
Reubicación de Canino
 Long-term prognosis of tooth autotransplantation: a
systematic review and meta-analysis
• Int J Oral Maxillofac Surg. 2016 May;45(5):610-7. doi: 10.1016/j.ijom.2015.11.010. Epub 2015 Dec 13.
• Authors
• L A Machado 1 , R R do Nascimento 2 , D M T P Ferreira 2 , C T Mattos 2 , O V Vilella 2
• Affiliations
• 1
Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Centro,
Niterói, RJ, Brazil. Electronic address: letmachado@bol.com.br.
• 2
Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Centro,
Niterói, RJ, Brazil.
• PMID: 26696138
• DOI: 10.1016/j.ijom.2015.11.010
 Long-term prognosis of tooth autotransplantation: a
systematic review and meta-analysis
• The aim of this study was to systematically review the prognosis of autotransplanted teeth
followed up for a period of 6 years or more. A literature search was conducted in five
databases and the eligibility criteria were established. The outcomes evaluated were the
survival rate, percentage of abnormal mobility, pulpal conditions, and percentage of root
resorption. The searches identified 1848 articles, and after evaluation against the eligibility
criteria, six were included. Data related to outcome measures were extracted from the studies
and a meta-analysis was performed. Survival rates ranged from 75.3% to 91% and the meta-
analysis showed an effect size of 81% (P<0.0001). The percentage ankylosis ranged from
4.2% to 18.2% and the effect size was 4.8% (P<0.0001). Root resorption percentages ranged
from 3% to 10% and the effect size was equal to 4% (P<0.0001). It was not possible to
perform a meta-analysis of data on pulpal conditions and percentage of teeth with abnormal
mobility. The results of this study showed the survival rate to be excellent, considering the
observation period. The rates of ankylosis and root resorption, despite their low values,
influence the prognosis of transplanted teeth.
• Keywords: autotransplantation; meta-analysis; prognosis; tooth.
• Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by
Elsevier Ltd. All rights reser
 Claves del Éxito
Desarrollo radicular ½ a
2/3 del diente donante
con ápice abierto (>
1mm)
Procurar indemnidad Extracción
de células del atraumática.*
ligamento periodontal.

Mantener el CONTROL DE Breve tiempo

diente en BIOFILM extraoral del
inoclusión. diente donante.

Poca manipulación
Fijación
del sitio
funcional.****
receptor.**
Sitio receptor
preparado con
anterioridad.*** Esquema 1:
Keys for Autotransplant Success.
Roden R. y cols, 2013.
 Conclusiones
Es una técnica confiable y predecible de reposición dentaria para
ciertos casos clínicos.

El cumplimiento estricto y depurado del protocolo propuesto por

Andreasen permite la obtención de altas tasas de éxito.

Es una opción terapéutica de bajo riesgo y costo para reposición

dentaria post trauma en pacientes pediátricos.

Permite la mantención de tejidos de soporte dentario, recuperación de

estética y funcionalidad.
 Outcomes and prognostic factors that influence the success of tooth
autotransplantation in children and adolescents.
•
PubMed Results
• Item 1-1 of 1 (Display the 1 citation in PubMed)
• 1. Dent Traumatol. 2017 Oct;33(5):393-399. doi: 10.1111/edt.12353. Epub 2017 Jul 14.

Outcomes and prognostic factors that influence the success of tooth autotransplantation in children and adolescents.

Kafourou V(1), Tong HJ(2), Day P(3), Houghton N(4), Spencer RJ(4), Duggal M(2).

Author information: (1)Private practice, Athens, Greece. (2)Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National
University of Singapore, Singapore. (3)Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK. (4)Department of
Orthodontics, School of Dentistry, University of Leeds, Leeds, UK.

BACKGROUND/AIM: Tooth autotransplantation has been advocated for replacement of missing teeth or teeth that are unsuitable for restoration.
The aim of this study was to investigate the outcomes and prognostic factors that influenced the success of tooth transplantation in a paediatric
population. MATERIALS AND METHODS: Data were extracted from the records of 75 patients (89 teeth). Demographic and prognostic factors
were recorded and analysed for the clinical and radiographic outcomes for periodontal ligament (PDL) and pulp healing of transplanted teeth.
RESULTS: The mean age at transplant was 13.2 years, and the mean follow-up observation period was 2.6±1.8 years with a range of 12.0 months
to 9.9 years. The main reason for transplantation was to replace upper central incisors lost or missing due to dental trauma, hypodontia and
dilaceration. Of the 45 teeth that were monitored for pulp revascularization, 75.6% showed clinical and radiographic signs of pulp healing and
24.4% showed signs of pulp necrosis and infection. Pulp healing was significantly related to the stage of root development of the transplant.
Favourable PDL healing was observed in 87.6% of the transplants, while 13.5% showed signs of replacement resorption. PDL healing was
significantly related to the stage of root formation of the transplanted tooth at the time of the surgery, the ease of handling and placement of the
tooth, and the status of the alveolar bone at the recipient site at the time of the surgery. Overall success of tooth transplantation was 87.6%, and the
survival rate was 94.4%. CONCLUSIONS: Tooth transplantation carried out in children and adolescents demonstrated high success and survival,
with the stage of root development influencing both the pulp and PDL healing of the transplanted teeth.

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

DOI: 10.1111/edt.12353 PMID: 28612428 [Indexed for MEDLINE]

 Bibliografía
• Optimizing Third Molar Autotransplantation: Applications of Reverse-Engineered
Surgical Templates and Rapid Prototyping of Three-Dimensional Teeth Ji-Man Park,
DDS, PhD,* Jacquiline Czar I. Tatad, DDS,y Maria Erika A. Landayan, DDS,z Seong-
Joo Heo, DDS, PhD,x and Sun-Jong Kim, DDS, PhD 2014 American Association of Oral
and Maxillofacial SurgeonsJ Oral Maxillofac Surg 72: 1653-1659, 2014
 Autotransplantation of Impacted Third Molar Using 3D Printing
Technology: A Case Report.
• 1. Bull Tokyo Dent Coll. 2019 Sep 7;60(3):193-199. doi: 10.2209/tdcpublication.2018-0058. Epub 2019 Aug 15.

• Autotransplantation of Impacted Third Molar Using 3D Printing Technology: A Case Report.

• Kamio T(1), Kato H(2).

• Author information: (1)Department of Oral and Maxillofacial Surgery. (2)Department of Endodontics, Tokyo Dental
College.

• Here, we describe a case of autotransplantation of a mandibular horizontally impacted third molar using a 3-
dimensional (3D) model based on limited cone-beam computed tomography (CBCT) images for diagnosis, 3D
morphological evaluation, preoperative treatment planning, and surgical simulation. A 27-year-old woman visited this
hospital for conservative treatment of the mandibular left second molar. Intraoral radiography and CBCT images
revealed a C-shaped root canal in the mesial root, and compressive resorption of the distal root due to impingement of
the crown of the horizontally impacted lower left third molar. Extraction was therefore planned. Multiple tooth-jaw
bone 3D models for preoperative diagnosis were fabricated using a low-cost desktop 3D printer and surgical simulation
of autotransplantation performed. The autotransplantation was then performed accordingly. Cone-beam computed
tomography images and 3D models were extremely useful in obtaining a stereoscopic understanding of the morphology
of the transplanted tooth and its surrounding anatomical structures. At the one-year postoperative recall, the patient
was able chew with the transplanted tooth without pain, and no significant abnormalities were detected on intraoral
radiographs, indicating a successful postoperative clinical course. Our experience of using 3D models fabricated based
on CBCT images using a desktop 3D printer for preoperative diagnosis and surgical simulation suggests that this
technique is useful in tooth autotransplantation.

• DOI: 10.2209/tdcpublication.2018-0058 PMID: 31413230 [Indexed for MEDLINE]

International journal of odontostomatology
versión On-line ISSN 0718-381X
Int. J. Odontostomat. vol.15 no.1 Temuco mar.
2021
http://dx.doi.org/10.4067/S0718-
381X2021000100271
ARTICLES

Autotrasplante Dental Utilizando Simulación

Virtual y un Prototipo de Modelo de Impresión
3D

Dental Autotransplantation Using Virtual

Simulation and a Prototype 3D Printing Model