2021 Volume 64 Issue 5 Pages 348-354
Purpose: Autotransplantation of non-functioning wisdom teeth is a viable and cost-effective treatment option for replacing compromised teeth, particularly in young patients where the transplanted teeth adapt to the growing maxilla or mandible. Furthermore, donor teeth with incomplete root formation or an open apex may remain vital after autotransplantation. This report describes the case of a seven-year follow-up of a young patient whose wisdom teeth with complete root formation were autotransplanted to the extraction sockets of two compromised first molars.
Patient: A 19-year-old woman visited the dental clinic for dental caries treatment. Her two first molars, 36 and 46, suffered from severe subgingival caries. She had three wisdom teeth, 18, 28, and 48, which were non-functional due to the absence of 38 and the mesial inclination of 48. Due to the difficulty of extracting 48 without splitting, 18 and 28 were selected as donor teeth for autotransplantation into the extraction sockets of 46 and 36.
Results: The severely compromised 46 was first extracted and replaced with 18. The severity of 36 was confirmed by removing the carious tissue and 36 was then replaced with 28. Based on radiographs, the cervical area of the transplanted tooth in 36 fitted well into the recipient socket, whereas 46 was small for the recipient socket, creating considerable space between the transplanted tooth and the mesial bone wall. The transplanted tooth in 46 did not react to the electronic pulp test two weeks after transplantation and was subjected to root canal treatment. In contrast, the transplanted tooth in 36 remained vital, requiring no endodontic treatment. When the temporary splints were removed three months after transplantation, no pathologic mobility was observed. The occlusal surfaces of the transplanted teeth were then adjusted by composite resin filling. At the 7-year follow-up, we observed no percussion pain, pathologic mobility, or discoloration on either transplanted tooth.
Conclusion: Two severely compromised teeth, 36 and 46, of a 19-year-old woman were replaced with non-functional wisdom teeth, 28 and 18. At the 7-year follow-up, we observed no symptoms on either transplanted tooth. One transplanted tooth received root canal treatment, while the other remained vital. For young patients, endodontic treatment of transplanted teeth should be carefully considered with reference to the results of a pulp viability test, irrespective of a completely formed donor tooth root.
