Autotransplantation of developing third molar in place of grossly destructed first molar – a clinical and radiological study.

Aims And Objectives: To evaluate the success rate of auto transplanted third molars. To consider the possibility of auto transplantation, in selected cases, as a good alternative to prosthodontic rehabilitation including implant insertion, when closing a gap in the dental arch. Materials And Methods: Ten patients of either sex with the age group between 15 to 19 years with developing third molars, having half or two third root development and simultaneously having first molar area in which the tooth is grossly destructed or heavily filled or which is indicated for extraction; with adequate bone support and which is free from acute infection and chronic inflammation are considered. The surgical procedure is performed under local anesthesia with strict aseptic measures. The transplanted tooth is stabilised with an open cap splint with coverage on the occlusal surface of the transplanted tooth. The splint is then secured in place by interdental wiring. Results: Out of 10 cases, clinically, all cases showed marked improvement and radiographically, one case exhibited replacement resorbtion and nine cases showed signs of continued root development but not much of root development was appreciable within one year duration. No abnormality was detected in relation to pulpal, periapical, periodontal conditions. All patients were able to carry out normal function over the transplanted area. Conclusion: Auto transplantation of teeth, when properly indicated and technically carried out with great care, will provide excellent results. It is worth consideration in any case in which there is suitable donor tooth available and so, in selected cases, this method should be preferred over prosthetic rehabilitation.

Severe hypoglycemia due to poorly differentiated hepatocellular carcinoma.

Hypoglycemia is a well documented paraneoplastic syndrome of hepatoma. Hypoglycemia as sole presentation is very rare. We report a case of poorly differentiated hepatoma with multiple lung metastases presenting with recurrent hypoglycemic seizures as the only manifestation four months before the diagnosis of the tumour.