a lot of dental procedures being utilized by consumers whether
for aesthetic purposes or medical, and tooth transplantation
is the most common one. Basically, this is done by moving a tooth
from a site to another site of the mouth and rarely to another
Studies showed that implants utilized in filling gaps of missing
front teeth are not the best alternative since this can cause
a considerable amount of bone loss and abrasion on neighboring
teeth and surrounding gums. Autotransplantation is considered
a better alternative in certain cases.
Autotransplantation (Autogenous tooth transplantation) is a
tooth surgical procedure in one location to another location
within the same person. Before, this was considered experimental,
but in present times auto-transplantation is a better alternative
for tooth replacement with high success rate. Indication for
clients opted for this procedure is narrow, and thorough patient
selection added with appropriate technique leads to outstanding
aesthetic and functional capabilities. One advantage of this
procedure is that the placement of implant-supported prosthesis
or other form of prosthetic tooth replacement is not essentially
Indications for auto-transplantation
Usually, autotransplantation is done because of tooth loss due
to dental caries, predominantly in the first molars of the lower
jaws. Early eruption of first molars is frequently restored.
In this case, the third molar is then removed via autotransplantation
and then transferred to the site of the first molar that is beyond
Transplantation can also be opted in cases like tooth agenesis
(premolars and lateral incisors), traumatic tooth loss, canine
atopic eruption, root resorption (body of the cells attack and
destroy a part of a tooth), large endodontic lesions, cervical
root fractures, and localized juvenile periodontitis.
Transplant success depends primarily on the specified requirements
from the client, donor tooth, and recipient site. Autotransplant
success is based on how well the healing takes place after the
procedure. A healthy tooth with undamaged periodontal ligament
will have higher degree of success.
Before having this procedure, clients must have a good health
and oral hygiene regimen. Most of all, a suitable donor tooth
and recipient site are required so that tooth can be replanted
The site should be well prepared in receiving the tooth donor.
Size should accommodate a tooth, along with sufficient alveolar
bone structure, which enables support. This should be free from
inflammation and infection.
The replanted Donor Tooth (the tooth) should be positioned to
assist in easy removal with minimum trauma possible. Mishapen
teeth or abnormal root morphology are not used in transplants.
Tooth length and development stage is vital in determining the
effectivity of a replantation wherein the tooth has between one-half
to two-thirds complete root development. So, autotransplantation
of the premolars where there is half to two thirds completed
root development have higher chances of pulp survival, with minimum
chances of necrosis (cell death).
Another factor influencing tooth development is the status of
epithelial root sheath or the covering. HERS or Hertwig’s
epithelial root sheath has a continuous production of cells that
separates a pulp to a dental follicle. HERS determines the root
growth by its degree of damage so the lesser the damage, the
greater chance of root growth post transplantation.
Teeth auto-transplantation with cryopreservation is an alternative
currently utilized for clients in a few clinics.
With cryobiology, cells or whole tissues are preserved by cooling
it to sub-zero temperature at around 77K or -196°C (boiling
point of liquid nitrogen). Low temperatures leads to prevention
of cell death (necrosis) and ceasing of biological activities
along with its biochemical reactions. Experiments on mice showed
effectivity of cryopreservation on the teeth, resulting to dental
tissue survival even at below freezing point.
Teeth cryopreservation requires a wider understanding of cryoprotective
mechanisms of cosolvents like dimethylsulfoxide (DMSO). Consequently,
only a few clinics have the expertise to do tooth cryopreservation
and make it available to their clients.
elevated numbers of healthy teeth extractions can be done for
amounts of donor teeth in cases of extensive surgical reconstruction.
Tissue banks for teeth tissues are regulated legally for quality
Surgical technique for tooth transplantation
The same amount of trauma is experienced by the client having
a removal of impacted molars to that that underwent tooth
transplantation. Sedation along with local anesthesia is
utilized in this case.
Once the effect of anesthesia is sufficient, then extraction
of the tooth at the recipient site and recipient socket is
Replantation of an acrylic replica of a tooth is done after
an x-ray and donor tooth scan. This replica will guide
technician to prepare a donor site for its dimension, etc.
Then, extraction of the donor tooth should have least damage
periodontal ligament and positioned quickly on the recipient
Instructions and follow-ups given to post operative clients
are similar in that of removal of tooth impaction. A soft
followed for several days post-surgery, and chewing on
the transplant should be avoided. Clients should always maintain
good oral hygiene.