[The periodontal ligament as a driver of dentoalveolar regeneration]

The periodontal ligament plays a central role in maintening and repairing the dentoalveolar complex. Unlike osseointegration around implants, the periodontal ligament functions as a dynamic, bone-remodelling system in which osteoclastic and osteoblastic processes are continuously coordinated. This enables it to actively maintain and regenerate bone, the periodontal space and soft tissues. Autotransplantation offers a unique clinical situation in which this biological potential is directly harnessed by transferring a vital periodontal ligament to a new location. In a donor tooth with an open apex and vital pulp, or with an endodontically treated, closed apex, the preservation of the periodontal ligament s vitality leads to predictable regeneration of alveolar bone, restoration of a physiological periodontal space and stable gingival contours, regardless of apical configuration and/or pulp vitality. This makes autotransplantation a clinically relevant option for tooth replacement, particularly in situations where long-term preservation of bone and soft tissue is essential.