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      Autotransplantation of a Supernumerary Tooth to Replace a Misaligned Incisor with Abnormal Dimensions and Morphology: 2-Year Follow-Up

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          Abstract

          Autotransplantation is a viable treatment option to restore esthetics and function impaired by abnormally shaped teeth when a suitable donors tooth is available. This paper describes the autotransplantation and 2-year follow-up of a supernumerary maxillary incisor as a replacement to a misaligned maxillary incisor with abnormal crown morphology and size. The supernumerary incisor was immediately autotransplanted into the extraction site of the large incisor and was stabilized with a bonded semirigid splint for 2 weeks. Fixed orthodontic therapy was initiated 3 months after autotransplantation. Ideal alignment of the incisors was accomplished after 6 months along with radiographic evidence of apical closure and osseous/periodontal regeneration. In autogenous tooth transplantation, a successful clinical outcome can be achieved if the cases are selected and treated properly.

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          Most cited references42

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          A long-term study of 370 autotransplanted premolars. Part II. Tooth survival and pulp healing subsequent to transplantation.

          The purpose of the present investigation was to determine the long-term prognosis of autotransplanted premolars with respect to tooth survival and pulpal healing. The material consisted of 195 patients aged 7 to 35 years, with a total of 370 autotransplanted premolars with observation period ranged from 1 to 13 years. Teeth transplanted with incomplete and complete root formation showed 95 per cent and 98 per cent long-term survival respectively: Pulp healing as evaluated by sensibility testing and radiographic signs of partial pulp canal obliteration was usually verified 6 months after transplantation. The frequency of pulpal healing (versus pulp necrosis), appeared to be closely related to stage of root development at time of transplantation. Teeth transplanted with incomplete and complete root formation showed 96 per cent and 15 per cent pulp healing respectively. Another and associated factor which could equally well predict pulpal healing was the diameter of the apical foramen of the graft. Finally, in teeth with completed root formation, the use of bursa with internal cooling and no extra-alveolar storage prior to transplantation seemed to increase the chance for pulpal healing. The present study indicates, that the size of the apical foramen and possibly the avoidance of bacterial contamination during the surgical procedure are explanatory factors for pulpal healing.
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            Outcome of tooth transplantation: survival and success rates 17-41 years posttreatment.

            The literature contains no follow-up studies of transplanted teeth with mean observation times exceeding 10 years. This article describes long-term outcomes, including gingival and periodontal conditions, and the patients' attitudes about treatment and outcome. The material comprised all accessible patients in the files of the Department of Orthodontics, University of Oslo, Norway, on whom treatment had been performed at least 17 years ago (n = 28). Established clinical criteria were used to assess tooth mobility, plaque and gingival indexes, and probing pocket depth. Standardized radiography was used to evaluate the presence of pathology, pulp obliteration, and root length. Similar recordings were obtained from the in situ tooth contralateral to the initial position of the grafted tooth. Criteria for determining treatment success were established. All patients responded to questions about their treatment using visual analogue scales. The mean age at surgery was 11.5 years, and the mean observation period was 26.4 years (range, 17-41 years). Of the 33 teeth transplanted in the 28 patients, 3 teeth were lost after 9, 10, and 29 years, respectively. Therefore, the 30 teeth in the 25 patients we examined yielded a survival rate of 90%. The success rate was 79% because 2 transplants had ankylosed, and 2 others failed to fulfill the proposed criteria. The patients generally responded very favorably regarding their perception of the treatment. Their only hesitation was related to some discomfort during surgery. It was concluded that survival and success rates for teeth autotransplanted when the root is partly developed compare favorably in a long-term perspective with other treatment modalities for substituting missing teeth.
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              Replantation of teeth. I. Radiographic and clinical study of 110 human teeth replanted after accidental loss.

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                Author and article information

                Journal
                Case Rep Dent
                Case Rep Dent
                CRIM.DENTISTRY
                Case Reports in Dentistry
                Hindawi Publishing Corporation
                2090-6447
                2090-6455
                2013
                11 February 2013
                : 2013
                : 146343
                Affiliations
                1Department of Pediatric Dentistry, Faculty of Dentistry, Baskent University, 11. Sokak No. 26, Bahcelievler, 06490 Ankara, Turkey
                2Department of Orthodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
                3Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey
                4Private Practice, 34100 Istanbul, Turkey
                Author notes

                Academic Editors: A. Celebić, Y.-K. Chen, C. Evans, C. S. Farah, and C. Landes

                Article
                10.1155/2013/146343
                3582062
                23476813
                d3962030-f330-4e63-9986-1526ee73c195
                Copyright © 2013 R. Ebru Tirali et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 October 2012
                : 3 January 2013
                Categories
                Case Report

                Dentistry
                Dentistry

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