Tooth autotransplantation combined with bone augmentation for reconstruction of the esthetic zone: A case report

Reconstruction of cleft-associated defects in the anterior maxilla is complicated by deficient hard and soft tissues, scarring, and altered anatomy. This case report describes tooth autotransplantation with simultaneous autogenous bone augmentation for replacement of a congenitally absent maxillary lateral incisor.

A 20-year-old male with agenesis of tooth #10 and previous cleft lip repair presented after 4 years of removable prosthesis use. Examination revealed horizontal and vertical ridge deficiency and residual oronasal communication. After surgical closure of the communication, tooth #20 was autotransplanted to site #10 following extraoral apical resection. Thin autogenous cortical plates and particulate bone harvested from the maxillary tuberosity were used simultaneously to augment the facial defect. An implant was subsequently placed at the donor site. Root canal treatment, direct composite restoration, and subsequent connective-tissue augmentation completed the rehabilitation.

At 12 months, the transplanted tooth remained functional and demonstrated grade I mobility, probing depths of 1.5-2.0 mm, and no bleeding on probing. No definite inflammatory or replacement root resorption was identified radiographically. The soft-tissue contour was improved, although partial remodeling of the augmented facial bone was evident.

Within the limitations of this case report, tooth autotransplantation with simultaneous autogenous bone augmentation allowed fixed tooth replacement and reconstruction of the deficient recipient site. This combined approach may represent a clinically relevant option in carefully selected patients when the available bone is insufficient for autotransplantation alone. Longer follow-up is required to assess its stability and long-term prognosis.

Digital planning and a printed donor-tooth replica facilitated donor selection and recipient-site preparation while limiting extraoral manipulation of the transplanted tooth. Simultaneous augmentation with thin autogenous cortical plates and particulate bone may support tooth autotransplantation when the available recipient-site bone is insufficient, although graft remodeling should be anticipated. Autotransplantation of a tooth with complete root formation requires careful surgical handling, appropriate endodontic management, and long-term monitoring for root resorption and ankylosis.