Dental autotransplantation (part 1): a management diagram

With its high success and survival rates, dental transplantation (surgical transposition of a tooth from its original site to another site within the same patient to compensate for missing or lost teeth), particularly for third molars, is a technique of significant interest in children and adolescents, i.e. for patients whose development is not yet complete, thereby precluding the immediate consideration of implant placement. Transplantation allows for the postponement or avoidance of implant placement, helps preserve the quality and quantity of space and bone, serves as a maintainer of bone and keratinized tissues, and, in optimal cases, authorizes certain orthodontic movements. The objective of this article is to propose an autotransplantation protocol in the form of a management diagram.

The management diagram was developed based on literature and our clinical experience.

The key clinical considerations are patient selection, 3D printing of replicas of the tooth to be transplanted using Cone Beam imaging (with elongated apices and gripping rod), preservation of periodontal tissues, minimizing extra-alveolar time (preferably through a two-step procedure or preliminary avulsion and site preparation), positioning the tooth in infraocclusion, and ensuring flexible and not overly prolonged support. À retention period of approximately four weeks is generally sufficient before resuming orthodontic movements.

Dental transplantation has greatly benefited from advances in 3D printing technology.