Experimental autogenous tooth transplantation in the dog: a comparison between one- and two-stage surgical techniques

Crucial if tooth transplantation is to succeed is preservation of the vitality of the cells of the periodontium and cementum of the tooth graft. Poor contact between the tissues of the recipient site and the root surface when teeth are transplanted to recipient sites prepared immediately prior to transplantation (one-stage technique) could, after transplantation, result in insufficient nutrition to the cells of the root surface and contribute to necrosis of the cells. To improve nutrition, tooth transplantation to recipient beds left to heal for 14 days was performed (two-stage technique). Clinical trials of tooth transplantation by the two-stage technique resulted in a low incidence of tooth graft loss and root resorption. The different results between these two methods, as well as difficulties in evaluating clinical trials, called for an experimental model to be established. In 5 beagle dogs, fully developed autogenous teeth were transplanted using both one-stage and two-stage surgical techniques. The control teeth were transplanted by the one-stage method to recipient beds prepared immediately before transplantation. The test teeth were transplanted using the two-stage method to recipient beds prepared and left to heal for 5 days prior to transplantation. Four pairs of teeth (1 test and 1 control) were transplanted in each dog. One pair of incisors and one pair of premolars were transplanted in the maxilla and in the mandible. Altogether 20 pairs of teeth were included in the study. One pair of teeth fractured during extraction and was therefore excluded from the study. Two pairs of teeth were lost in the first hours after transplantation. Evaluation of the remaining 17 pairs of teeth was made by routine histological examinations after a 6-month period of healing. The blinded examination failed to show a difference between the two surgical methods in terms of frequency of various types of root resorption. The differences between the results after long-term observation of human teeth transplanted by the one- and two-stage tooth transplantation techniques were not found by this experimental model.