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. 2022 Sep 23;27(4):e22spe4.
doi: 10.1590/2177-6709.27.4.e22spe4. eCollection 2022.

Dental autotransplantation as a alternative treatment for the loss of permanent anterior teeth in children

Marcos Flávio Spínola Ambrósio  1 , Renata Pittella Cançado  1 , Bruna Carolina Gonçalves de Oliveira  2 , Marco Antônio Masioli  3 , Deise Lima Cunha  4
Affiliations

Dental autotransplantation as a alternative treatment for the loss of permanent anterior teeth in children

Marcos Flávio Spínola Ambrósio et al. Dental Press J Orthod. .

Abstract
in English, Portuguese

Introduction: Autotransplantation is defined as the surgical movement or transposition of a tooth from its original site to a recipient alveolus, in the same patient. It has high success rates when performed within predefined parameters.

Objective: This study aims to describe the advantages of a dental autotransplantation protocol based on a multidisciplinary approach and using cone beam computed tomography, computer-aided planning, and rapid prototyping of the donor tooth, enabling the preparation of a surgical guide and postoperative protective plate. This article discusses the indications and contraindications for autotransplantation, as well as the selection criteria for the tooth to be transplanted and the transoperative care essential for its success. The parameters for post-operative control are described, in addition to the variables of success and failure to be considered.

Conclusions: When analyzing the treatment options available for children with anterior tooth loss and the psychosocial impact on these patients, autotransplantation is considered not only an alternative treatment, but the only viable option for their functional, aesthetic, and social reestablishment.

Introdução:: O autotransplante é definido como a transposição cirúrgica de um dente do seu local original para um alvéolo receptor no mesmo indivíduo, e apresenta altas taxas de sucesso, quando realizado dentro de parâmetros predefinidos.

Objetivo:: O presente estudo tem como objetivo descrever as vantagens de um protocolo de autotransplante dentário baseado em uma abordagem multidisciplinar e utilizando tomografia de feixe cônico, planejamento assistido por computador e prototipagem rápida do dente doador - possibilitando a confecção de um guia cirúrgico e placa protetora pós-operatória. Nesse artigo, serão discutidas as indicações e contraindicações do autotransplante, assim como os critérios de seleção do dente a ser transplantado e os cuidados transoperatórios essenciais para o seu sucesso. Serão descritos os parâmetros para controle pós-transplante, assim como as variáveis de sucesso e insucesso a serem consideradas.

Conclusão:: Ao analisar as opções de tratamento disponíveis para crianças com perdas dentárias na região anterior e o impacto psicossocial nesses indivíduos, deve-se considerar que o autotransplante não se constitui somente em uma alternativa de tratamento, mas sim na única opção viável para o restabelecimento funcional, estético e social desses pacientes, reinserindo-os em seu meio.

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Conflict of interest statement

The authors report no commercial, proprietary or financial interest in the products or companies described in this article.

Figures

Figure 1:
Figure 1:. Ideal indications for replacement of lost dental elements.
Figure 2:
Figure 2:. Patient with missing right maxillary central incisor (#11)(A), left maxillary central incisor (#21) with root canal treatment (B), presenting replacement resorption. Donor tooth in the ideal period for carrying out the transplantation (C, D).
Figure 3:
Figure 3:. Initial extraoral and intraoral photographs.
Figure 4:
Figure 4:. Initial radiographs and cephalometric tracing.
Figure 5:
Figure 5:. Initial tomography of the maxilla (A). Segmentation of possible elements to be transplanted (B). Positioning of the chosen dental element in the alveolus of the lost tooth (C, D).
Figure 6:
Figure 6:. Superimposition of maxillary CBCT, intraoral scan and segmented dental element chosen, for the construction of the surgical guide.
Figure 7:
Figure 7:. Printed surgical guide and prototype of the tooth to be transplanted.
Figure 8:
Figure 8:. A) Proof of the surgical guide. B) Making the alveolus. C) Proof of the prototype in the prepared alveolus. D) Transplanted tooth into position and stabilized.
Figure 9:
Figure 9:. Impression of the post-transplantation model (A), for making the protection plate (B).
Figure 10:
Figure 10:. A) Mandibular second premolar positioned at the maxillary central incisor site. B) Immediately after the reshaping of the premolar into a central incisor.
Figure 11:
Figure 11:. Reshaping and restoration of the transplanted tooth.
Figure 12:
Figure 12:. Photographic and radiographic control: A) initial; B) post-surgical; C) post-restoration.
See this image and copyright information in PMC

References

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