2013 Volume 56 Issue 3 Pages 252-263
Purpose: A nonfunctional tooth can be utilized in tooth transplantation, which could eliminate the need for dentures. Many case reports claim a good prognosis following tooth transplantation, but in most cases involving the lower jaw, the residual bone mass in the recipient site is limited. We report a case of autotransplantation of teeth to the areas close to the maxillary sinus, which helped eliminate the need for dentures. Case Report and Results: A 61-year-old woman consulted our department with the chief complaint of painful right maxillary molars. She had been diagnosed with type II diabetes mellitus (HbAlc: 6.5%) since 1996 and was receiving insulin therapy by self injection. At the initial consultation, the right maxillary first molar was extracted because of poor prognosis. In addition, preservation of the left maxillary first molar was deemed impossible because of root fracture. The patient expressed strong antipathy towards the use of dentures. Therefore, we checked the possibility of dental implant therapy and observed that the distance to the maxillary sinus base was too short to insert an implant and the sinus mucosa was swollen. We decided that implantation with sinus floor augmentation was impractical. Therefore, we opted for bilateral autotransplantation of the third mandibular molars to the maxillary arch. After the initial periodontal therapy, 48 was transplanted to the 16 region, along with inversion of the mesiodistal direction considering the distance and tooth root form in relation to the maxillary sinus base. Provisional restoration was provided for 3 months post-transplantation. After confirming the stability of the transplanted tooth, 38 was transplanted to the 26 region, and provisional restoration was provided for 3 months post-transplantation. After 29 and 22 months post-transplantation in the maxillary right and left sides, respectively, we confirmed the stability of the transplanted teeth as the final prosthesis. Discussion: In this case, with regard to transplantation to an area of severe alveolar bone resorption, we were concerned about residual alveolar bone mass, but the feasibility of transplantation was verified using cone beam computed tomography (CBCT) to measure the alveolar bone thickness and its distance from the maxillary sinus base. Using this method, a missing tooth portion was treated safely without implantation. Conclusion: In this case requiring treatment in areas close to the maxillary sinus, we demonstrated that the use of dentures can be avoided by tooth transplantation and using CBCT.
