[Auto-transplantation of tooth germs. Discussion and presentation of 3 treated cases]

The authors examine the theoretical possibilities of human dental transplants: autologous, homologous and heterologous. They, then discuss-with reference to autologous transplants-an autotransplant as an alternative to prosthodontic treatment. This would apply both to traditional prosthodontic treatment and on implants or orthodontic treatment aiming at filling dental gaps. They show both general and local counterindications against this operational method the knowledge of which is necessary for an adequate selection of patients. They stress the determining factors for a successful autotransplant: 1) particular care with the choice of the germ to be transplanted taking into account its morphology and the stage of root development; 2) adequate surgical preparation of the receiving site in relation to the size of the germ to be transplanted; 3) suitable surgical technique entailing a particular care in the manipulation of soft and hard tissues and of the germ and appropriate conditions of sterilization; 4) use of appropriate retention means to ensure stability of the transplanted germ so as to favour cellular proliferation and reduce osteoclastic activity; 5) reduction of occlusal pressure on the transplanted germ. The authors describe for example's sake 3 out of 32 cases treated with the documentation of the achieved long-term success. They also analyse the possible causes of failure of such operational method (careless manipulation of the germ, incorrect surgical technique, removal of the germ in a too early stage of its development, too long exposure of the germ outside the oral cavity, poor oral hygiene, caries, periodontal disease, occlusal trauma.