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Do Autotransplanted Teeth Require Elective Root Canal Therapy? A Long-Term Follow-Up Case Series
1Senior Specialty Dentist in Oral Surgery, Oral Surgery Department, Guy's Hospital, London, UK.
Summary
Autotransplanted teeth with complete root formation may not routinely require root canal therapy (RCT). Close monitoring can reveal potential for revascularization, suggesting a revised protocol for these cases.
Area of Science:
- Dental surgery
- Oral and Maxillofacial Surgery
- Endodontics
Background:
- Autotransplantation of teeth is a common procedure.
- Root canal therapy (RCT) is often performed electively after autotransplantation.
- The necessity of routine RCT for teeth with complete root formation is debated.
Purpose of the Study:
- To evaluate long-term survival and outcomes of autotransplanted teeth.
- To determine if elective RCT is routinely required for teeth with complete root formation post-autotransplantation.
Main Methods:
- Retrospective analysis of 252 autotransplanted teeth in 209 patients.
- Minimum follow-up of 1 year, maximum of 29 years.
- RCT was performed only for teeth with signs of internal resorption (IR), external resorption (ER), or pulpal necrosis.
Main Results:
- Overall failure rate was low, with high survival rates at 1, 5, and 10 years.
- 18% of teeth showed signs of IR, ER, or apical pathology (AP).
- 59.3% of teeth with complete root formation, followed for at least 5 years, showed no pathology and did not require RCT.
Conclusions:
- Autotransplanted teeth with complete root formation may revascularize with close monitoring, potentially avoiding routine RCT.
- The protocol for elective RCT after autotransplantation may need reconsideration.
- Further long-term studies using Doppler flowmetry are recommended to assess vascularity.
