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Autotransplantation
Dr. McDonald
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Dr. Janakievski
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ages of 9 and 12 years. Most traumatic injuries to anterior
teeth seem to occur during this same period, making autotransplantation a good option for these patients (Figure 1).
Figure 1
Panograph
Figure 2a
Figure 2b
Figure 2c
Osteotomy preparation
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Figure 3a
2 months
Figure 3b
4 months
Figure 3c
7 months
Figure 2d
JJ: Certainly
the next phase
of treatment will
involve coordination between the
orthodontist and
the restorative
dentist. Since the premolar is
usually smaller than a central
incisor, it must be very specifically positioned to allow for ideal
Figure 3e
restoration. For the incisogingival
RDUOGRAPH
7 MONTHS
position, the orthodontist must
use the cemento-enamel junction (CEJ) of the contralateral
incisor as a guide. Positioning the
transplanted tooth so that the CEJ
is lined up with the adjacent central incisor minimizes the risk
of developing uneven gingival margins as passive eruption occurs. In order to minimize future prosthetic tooth preparation,
positioning must also take into consideration both the form of
the transplanted tooth and the restorative procedure (bonding,
veneer, crown) that will be used to normalize it. Since a central
incisor has a straighter mesial contour and a more curved distal
contour than a premolar, the tooth must be positioned with
two-thirds of the residual space to the distal. To minimize the
amount of enamel reduction that needs to be done on the facial,
the transplant should be positioned slightly palatal on the ridge.
Various restorative techniques or materials can then be utilized
to change the morphology of this tooth (Figure 4).
Figure 3d
Radiograph
day 1
transplant
continued
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Practitioners
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Figure 4a
Figure 4b
bEFORE
RESTORATION
rESTORATION
WITH COMPOSITE VENEER
Figure 5a
Description
Figure 5b
rADIOGRAPH
PRE-OP
Figure 5c
eXPOSURE
OF CENTRAL
INCISOR
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2 years that would cover the surgical, orthodontic, and restorative aspects of autotransplantation.
References
1. Czochrowska EM, Stenvik A, Bjercke B, Zachrisson BU.
Outcome of tooth transplantation: survival and success rates
17-41 years posttreatment. Am J Orthod Dentofac Orthop.
2002;121(2):110-119.
2. Andreasen JO, Paulsen HU, Yu Z, Ahlquist R, Bayer T, Schwartz
O. A long-term study of 370 autotransplanted premolars,
III:periodontal healing subsequent to transplantation. Eur J Orthod. 1990;12(1):25-37.
Figure 5d
2 MONTHS
3. Andreasen JO, Paulsen HU, Yu Z, Bayer T, Schwartz O. A longterm study of 370 autotransplanted premolars, II:tooth survival
and pulp healing subsequent to transplantation. Eur J Orthod.
1990;12(1):14-24.
4. Rauth RJ, Potter KS, Ngan AY, et al. Dental enamel: genes define
biomechanics. J Calif Dent Assoc. 2009;37(12):863-868.
5. Kim K, Lee CH, Kim BK, Mao JJ. Anatomically shaped tooth
and periodontal regeneration by cell homing. J Dent Res.
2010;89(8):842-847.
Figure 5e
1 YESR
Figure 5f
dAY OF
SURGERY
AND
1 YEAR
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