Primary tooth autotransplantation: update and retrospective clinical study.

OBJECTIVE: A new technique of primary tooth autotransplantation has recently been published demonstrating reliable replacement of missing permanent incisors in young children due to trauma or agenesis. This retrospective clinical study reports on the longterm success of this new technique in a larger patient group regarding its potential to support bone and soft tissue growth. STUDY DESIGN: 40 children (age range: 2.7-17.6 years) received 53 primary tooth autotransplants (49 canines and 4 incisors) due to traumatic tooth loss (73%), agenesis (19%) or dysplasia/displacement (8%). Clinical and radiological follow-up examinations were performed to check up on root resorption, bone and soft tissue growth, survival and success. RESULTS: 22 transplants still present in the oral cavity of 18 patients yielded a success rate of 77%. The Kaplan-Meier estimator measured a median survival time of 86 months (7.2 years) for all 53 grafts. In all cases, increasing soft tissue and bone development enabled a successful prosthetic rehabilitation regarding aesthetics and function. CONCLUSIONS: Primary tooth autotransplantation reliably restores edentulous anterior space in children experiencing traumatic tooth loss or agenesis and acts as an immediate therapy before other therapies such as premolar transplantation or orthodontic space closure can be carried out at a later time. It guarantees the co-development of soft tissue and bone in the teenage jaw which is associated with high patient satisfaction and acceptance of this method.

The influence of storage temperature on fracture behavior of cryopreserved teeth-An in vitro study.

OBJECTIVES: Cryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long-term prognosis of the teeth. MATERIAL AND METHODS: Twenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at -80°C (group 1) and -196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load. RESULTS: No significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests. CONCLUSIONS: Conclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.

Premolar autotransplantation in juvenile dentition: quantitative assessment of vertical bone and soft tissue growth.

OBJECTIVE: Premolar autotransplantation represents an effective therapeutic option for the treatment of juvenile dentition with either aquired or congenital hypodontia. The objective of this prospective clinical study was to quantitatively assess bone and soft tissue levels after autogenous premolar transplantation by clinical and radiographic parameters. STUDY DESIGN: In the study, 26 premolars were transplanted in 20 patients after traumatic tooth loss (n = 16) or congenital aplasia (n = 10) in the anterior maxilla. Based on standardized photographic documentation, the relative soft tissue level was measured compared to the healthy adjacent teeth. Radiographic findings included evaluation of root resorption, pulp canal obliteration, and relative bone height. RESULTS: Average survival rate of transplanted premolars (n = 26) was 100% over a follow-up period of 29 months (range 10-60 months). The relative soft tissue level significantly increased by +1.1 mm (P < .01). Radiographs showed a tendency toward vertical bone growth. Continuous root development and signs of pulpal healing were observed postoperatively in 18 transplants (69.2%). CONCLUSIONS: Autogenous premolar transplantation represents a safe method to ensure functional and aesthetic rehabilitation in the anterior maxilla irrespective of the nature of tooth loss.

Laser therapy of a dermal nevus in the esthetic zone of the nasal tip: A case report and comprehensive literature review.

This case report demonstrates the ablation of a dermal nevus using a diode laser in the esthetically very demanding facial area of the nasal tip. The clinical outcome shows good results and a high level of patient satisfaction. Due to effective wound granulation and healing, elaborate skin grafts could be avoided. The application of the contact laser ensures safe treatment in highly perfused areas thanks to haptic feedback and good coagulative effect. The method should therefore be considered as an alternative to other ablative procedures for benign lesions in the facial area.

Primary canine auto-transplantation: a new surgical technique.

OBJECTIVE: The aim of this study was to investigate whether the growth of soft tissue and bone in children with traumatic tooth loss or agenesis of teeth can be developed reliably, using a new technique of autogenous primary canine transplant. STUDY DESIGN: A total of 10 patients (age range, 7-13 years) were treated either for trauma or for agenesis (n = 14 primary canine transplants). In addition to the clinical examination, patients were subjected to radiologic examinations with regard to root resorption, bone height, and soft tissue level. RESULTS: With an average survival rate of 87%, the average survival time of the transplants using the Kaplan-Meier estimator was 5.2 years. In all cases, soft tissue and bone growth was effectively developed. CONCLUSIONS: Autogenous primary canine transplant is a reliable surgical method for rehabilitating children in the early mixed dentition after traumatic tooth loss, enabling adequate soft tissue and bone growth.

Autotransplantation and surgical uprighting of impacted or retained teeth: A retrospective clinical study and evaluation of patient satisfaction.

OBJECTIVES: This retrospective clinical study aimed to determine the success rate of autotransplanted impacted or retained teeth along with a patient satisfaction survey and to analyze the influence of relevant clinical and radiographic parameters. SUBJECTS AND METHODS: Fifty-seven teeth (37 canines, 10 molars, seven premolars, three incisors) in 45 patients (median 15 years) were evaluated over a mean of 1.6 years. The success criteria were pocket probing depth ≤3.5 mm, mobility grade ≤ II, Periotest ≤30 and complete alveolar bone healing. The influencing parameters were oral hygiene, smoking, periodontal screening index, occlusal/proximal contacts, horizontal position, dental age, pulp obliteration and degree of displacement. Furthermore, bone height was measured. RESULTS: The overall success rate was 74%, along with a high patient satisfaction. The survival rate was 96% after a mean follow-up of 1.6 years. The favorable factors were proper oral hygiene, non-smoking, good general periodontal condition, proximal contacts and pulp obliteration. An increase in or maintenance of bone level was found in 96%. CONCLUSIONS: Autotransplantation of impacted or retained teeth is an appropriate treatment, if orthodontic alignment has failed, especially in growing patients.