Successful Autotransplantation of Third Molar in a Patient with Mental Retardation

Abstract

The restoration of occlusal function after tooth loss should be considered carefully in patients with mental retardation, because of their lack of understanding about oral hygiene and ability to adapt to removable dental prostheses such as partial dentures. Autotransplantation of teeth is one useful option for occlusion recovery after loss of teeth. However, autotransplantation is generally contra-indicated in patients with cardiac anomalies, poor oral hygiene and lack of self-motivation including mental retardation. We herein describe the successful autotransplantation of an impacted maxillary third molar tooth into the extraction site of a decayed mandibular first molar in a 22-year-old female patient with mental retardation and dental phobia. First, we repeatedly explained our treatment plan to the patient and her mother until they could understand it. Then we applied the behavior management “Tell-Show-Do” technique and intravenous sedation with midazolam and propofol to the patient for the dental treatment to alleviate her anxiety and stress. Three months after autotransplantation, dental treatment of the transplanted tooth was started and after 6 months, the treatment was finished successfully. In a patient with mental retardation, autotransplantation of teeth can be an effective treatment to restore the occlusion provided that such cases are carefully selected.