Reconsidering some standards in immediate autotransplantation of teeth: Case report with 2-year follow-up

INTRODUCTION: Dental autotransplantation (DAT) is that surgical procedure of extracting a tooth from one place (donor site) and transplanting it into another (recipient site) within the same individual. If successfully implemented, the treatment outcome will pose characteristics of a natural tooth rather than a dental prosthesis. This case report sheds light on the validity of this treatment option, and provides suggestions to reconsider some standards regarding its conventional protocols. CASE PRESENTATION: A 24-year-old female with no history of medical conditions presented with hopelessnon-restorable lower molars with clinical signs of chronic infection. Cone-beam computed tomography (CBCT) was used to check compatibility of her third molars for DAT. After clinical and radiographical examination, patient's consent to perform DAT of impacted upper right third molar to replace the lower right first molar was obtained. Based on patient's CBCT, an individual replica of the donor tooth was fabricated. Replica helped in pre-preparing recipient site to fit the dimensions of the donor tooth before being extracted and transplanted. The extraction socket was thoroughly debrided and irrigated to ensure the removal of any lesion or infection. Immediate DAT was carried out with minimal trauma to the transplant. Follow-up for 2 years showed functional transplant with uneventful healing of periodontal and pulpal tissues. CONCLUSION: Some standards regarding DAT needs to be reconsidered. Routine prophylactic endodontic treatment is not necessary for every case of DAT even when transplanted tooth is mature. Immediate autotransplantation into an infected site can be successful if the recipient site is managed properly.