(TC32) Autotransplantation of Donor Tooth #16 to Recipient Site #3 for Esthetic and Functional Improvement

Abstract: A 25-year-old Asian female was referred from the Penn Dental Medicine (PDM) Periodontics-Orthodontics clinic to the PDM Endodontics clinic for an evaluation for autotransplantation. Oral examination showed missing teeth #3 and #4. The patient was unsatisfied with the esthetics and preferred not to have implants to replace the missing teeth, and also sought orthodontic treatment for malocclusion and crowding. A three-dimensional evaluation of potential donor teeth #16 or #32 for the recipient site of #3 was performed. Compared to tooth #32, tooth #16 had optimal root anatomy for extraction/replantation and was chosen as the donor tooth for this case. Prior to surgery, root canal treatment of #16, placement of an orthodontic spacer, and printing of a 3D analogue in various sizes were all completed. During surgery, atraumatic extraction and limited extra-oral time were determinants of the prognosis for the autotransplantation. Once extracted, root-end resection/bioceramic root-end filling were performed on tooth #16, ensuring infraocclusion after transplantation. A short-term semi-rigid splint was placed to stabilize the transplanted tooth. Multiple follow-ups demonstrated healing of the surgical site with new bone formation around the transplanted tooth.