[Tooth transplantation].
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Allotransplantation (grafts between dissimilar members of same species) of teeth has been used for many centuries. The grafts are rejected after various postoperative periods because of histoincompatibility between donor and recipient. However, cases with a comparatively long survival time are seen. Suppression of the host's immune mechanisms is for the present time fraught with dangerous side effects, and is for this reason not applicable in cases of tooth transplantation. Another possibility is to genetically match the donor and recipient. The normal lymphocyte transfer (NLT) test was the first method used in this respect. The author attempted this method and reports the results of 32 allotransplanted teeth after an observation time of 16 years.
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Statistical analysis of paired observations indicated that RhLA-A,B disparate teeth caused the accelerated rejection of tooth-donor skin grafts placed 21 to 24 mo after tooth allotransplantation, but not at 30 to 34 mo. Teeth transplanted between matched monkeys did not cause the accelerated rejection of skin grafts.
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The aim of the present study was to perform a retrospective study of autogeneously transplanted teeth in order to examine the influence of clinical criteria such as the type of the donor tooth, the root length at the time of transplantation, donor eruption stage and others on the overall success rate of the transplantation. The material of this study consisted of 194 patients in whom 273 teeth were transplanted. The mean age at the time of autotransplantation was 18.1 years with a standard deviation of 7.5 years. Transplantations were performed in two hospitals. The follow-up period varied from 15 days to 11 years, and the mean follow-up time was 3.8 years. 58/273 teeth showed one or other form of resorption, 37/273 teeth showed ankylosis, 30/273 showed no important changes in pulp chamber size, 104/273 showed major discoloration after transplantation, 92/273 teeth showed positive results for cold test after transplantation and 26/273 teeth showed clinically unacceptable pocket depth. Clinical and radiological evaluations were performed. An association was found between successful transplantation and donor tooth type (P<0.01), root length at the time of transplantation (P<0.0001) and recipient tooth site (P=0.03). There was a borderline association between successful transplantation and donor eruption stage (P=0.05). In conclusion, autotransplantation of teeth performed with a careful surgical procedure at the stage of 1/2-3/4 of their intended or expected root length can render a very useful service to patients.
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