Endodontic management of autotransplanted teeth
Objectives
The aim of our research was to observe the periodontal ligament formation and resorption issues due to the endodontic treatment after autotransplantation of third molars with closed tip in adults. In this study, we want to determine the quality of reattachment appeared depending on the quantity of periodontal fibres in recipient zone, and the type of resorption in a sequence of endodontic treatment.
Materials and methods
In the study we observe 50 patients who did undergo autotransplantation of third molars with a closed root tip. All clinical cases are divided into three groups. The 1st group is presented by autotransplantation in a fresh socket without signs of inflammation. The 2nd group - in a fresh socket, with the presence of a chronic inflammatory process and in the 3rd group the socket was prepared in native bone. The transplanted teeth were endodontically treated before, during the operation or in 14 days after the operation. After removing a splint (the average time of splinting is 30 days) the objective measurements were done. All autotransplanted teeth were put in the occlusion.
Case #1 (1st group)
Case #2 (2nd group)
Case #3 (3rd group)
Results
The first results were evaluated after 3 and 6 months. mobility was 36 (72%), I - 9 (18%), II - 4 (8%) and III - 1 (2%), ankylosis (AN) - 0. After 6 months, 41 teeth had normal mobility (82%), I - 4 (8%), II - 1 (2%), III - 1 (2%), AN - 3 (6%).
The depth of periodontal attachment did not exceed 3 mm, but in 8 cases (16%) there were recessions according to I Miller class. These parameters were stable from 3 till 6 months. During the X-ray examination, it was found after 3 months that in 26 (52%) cases, PDL did not differ significantly from the PDL of adjacent teeth. In 15 (30%) cases PDL had an uneven narrow structure, less than 1 mm thick. In 3 cases (6%), signs of replacement resorption were found and in 6 (12%) PDL expansion was observed. After 6 months in 41 (82%) cases there were no signs of PDL abnormality, excepting the thinness.
Authors: Badalyan Kristina, Zedgenidze Alena
Literature cited
- Schwartz O1, Andreasen JO. J Oral Maxillofac Surg. 1988 Aug;46(8):672-81. Allotransplantation and autotransplantation of mature teeth in monkeys: the influence of endodontic treatment.
- Andreasen JO1, Paulsen HU, Yu Z, Schwartz O. Eur J Orthod. 1990 Feb;12(1):14-24. A long-term study of 370 autotransplanted premolars. Part III. Periodontal healing subsequent to transplantation.
- Yu HJ1, Jia P1, Lv Z1, Qiu L. Int J Oral Maxillofac Surg. 2017 Apr;46(4):531-538. Epub 2017 Jan 3. Autotransplantation of third molars with completely formed roots into surgically created sockets and fresh extraction sockets: a 10-year comparative study.