Oral Health and Dental Management

Autotransplanted premolars: Possibilities and long-term evaluation

4^th Asia Pacific Congress & Expo on Dental and Oral Health

July 27-29, 2015 Brisbane, Australia

H U Paulsen and O Schwartz

Posters-Accepted Abstracts: Oral Health Dent Manag

Abstract:

Objective: The aim of this study was to present the topic, possibilities and long-term evaluation of survival and failures of autotransplanted premolars, followed more than 30 years. Materials & Methods: This study investigated a consecutive group of one hundred patients treated with autotransplantation caused tooth loss, hypodontia and ectopic tooth position. All patients (9.2-14.4 years, mean 12.8), 53 boys and 47 girls, had one-rooted premolars transplanted from one region to another. Totally 118 premolars were transplanted in root stages with an open apex wider than 1 mm. Primary healing and follow-up were tested using a Siemens electrometric pulp tester to detect pulpal reinnervation and standardized radiographs to test transplant healing and root development generally. Assessments were carried out at 1, 4, 8, 12 and 24 weeks and thereafter yearly after transplantation. Tooth eruption and root development was evaluated using a color coding technic, developed at the Karolinska Institute, Stockholm. Transplants were moved or rotated orthodontically 3-9 months after transplantation. Results: Complicated problems were moved to other regions or replaced, easier to solve orthodontically. Most transplanted premolars showed normal tooth eruption, compared with contra laterals. Transplants induced tooth eruption and bone induction. Transplants erupted before visible root formation and before visible alveolar bone formation. Furthermore, marginal gingiva was transferred with both papillae. It was found successes of 91.5% and failures of 8.5% for all transplants. Premolars transplanted as maxillary incisors had a higher incidence of failures (15%) than premolars transplanted to the mandibular premolar regions (7.6%). Conclusion: Marginal gingiva was transferred with both papillae. Transplantation induced tooth eruption and bone induction. Transplantation of one-rooted premolars carried out by a trained oral surgeon had a long-term survival of 91.5%. The method can therefore be taken into account in the orthodontic treatment planning.