Long-Term Follow-Up of Multiple Autotransplantations Combined With Orthodontic Treatment After Traumatic Dental Injury: A Case Report

Abstract

In this case report, we present the treatment of an adult patient who had experienced dental trauma resulting in the loss of one tooth and damage to two others. The patient was referred to our clinic 4 years after the accident, where a comprehensive examination revealed external root resorption and loss of supporting tissue. To address the patient's concerns, we developed an interdisciplinary treatment plan, which included orthodontic treatment to level the curve of Spee, reduce the deep bite, and extrude the affected teeth. After that, we extracted the damaged Teeth 2.1 and 2.2 due to their poor prognosis and replaced them with autotransplantation of Teeth 1.4 and 3.1. Before the procedure, both teeth underwent endodontic treatment, and 6 weeks later, they were built up to aesthetically and functionally replace the lost teeth. Additionally, postautotransplantation orthodontic treatment was conducted to close the donor site space and bring the autotransplanted teeth to an ideal position. The interdisciplinary approach and successful treatment of this case suggest that autotransplantation can be a valid option for restoring compromised teeth, especially in adult patients who require orthodontic treatment. In conclusion, autotransplantation offers multiple benefits, including preserving the natural dentition, avoiding the use of dental implants or prostheses, and achieving excellent aesthetic and functional results. Furthermore, this case underscores the importance of individualized treatment planning and collaboration among dental specialists to achieve optimal outcomes for patients.

Keywords: autotransplantation; case report; dental traumatology; multidisciplinary treatment; orthodontic treatment.

Figure 1

Facial analysis, panoramic and lateral radiographs, and cephalometry before treatment start.

Figure 2

Intraoral photographs at treatment start.

Figure 3

Lower arch bonding.

Figure 4

Radiographic evaluation of Tooth 2.1 during extrusion and Tooth 1.4 after its transplantation and bonding.

Figure 5

Intraoral details of autotransplantation of Tooth 1.4 to Tooth 2.1's site, its reconstruction, and extrusion of Tooth 2.2.

Figure 6

Extrusion of Tooth 2.2 for vertical development of the alveolar bone.

Figure 7

Intraoral details of autotransplantation of Tooth 3.1 to Tooth 2.2's site.

Figure 8

Reconstruction and bonding of the transplanted Tooth 3.1.

Figure 9

Radiographic evaluation of Tooth 3.1 during extrusion and after its transplantation and bonding.

Figure 10

Detailing and finishing before final direct restorations.

Figure 11

Intraoral radiographs at treatment end.

Figure 12

Facial analysis, panoramic and lateral radiographs, and cephalometry after treatment end.

Figure 13

Five-year follow-up intraoral photographs.

Figure 14

Five-year follow-up extraoral photographs.

Figure 15

Radiographic follow-up after 8 and 7 years since the autotransplantation of Teeth 2.1 and 2.2, respectively.