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Autogenous tooth transplantation: an alternative to dental implant placement?

Autogenous tooth transplantation, or autotransplantation, is the surgical movement of a tooth from one location in the mouth to another in the same individual. Once thought to be experimental, autotransplantation has achieved high success rates and is an excellent option for tooth replacement. Although the indications for autotransplantation are narrow, careful patient selection coupled with an appropriate technique can lead to exceptional esthetic and functional results. One advantage of this procedure is that placement of an implant-supported prosthesis or other form of prosthetic tooth replacement is not needed. This article highlights the indications for autogenous tooth transplantation using 3 case reports as examples. A review of the recommended surgical technique as well as success rates are also discussed.

Adolescent↗

[Results of measuring tooth mobility by a two-parameter periodontometer].

A new method for evaluating mobility of a tooth and area of its periodontium is suggested. The evaluation of elastic and viscous components of tooth mobility is based on theoretical estimations. Clinical evaluations of tooth mobility were carried out in patients with physiologically normal periodontium making use of a two-parametrical periodontometer. Experiments demonstrated that the ratio of elastic to viscous components of the tooth mobility is proportionate to periodontal area. Two-parameter periodontometer gives data on complete mobility of a tooth and periodontal area.

Diagnosis, Oral↗

[Supercomplect retained tooth is the cause of delayed eruption of the upper central left incisor. Therapy].

Supercomplect retained tooth, a mechanical obstruction preventing the eruption of 21st tooth, is the cause of delayed eruption of the upper central left incisor. After removal of the supercomplect retained tooth, extension of the upper dental arch, normalization of occlusion, and creation of space for 21st tooth in the dental row, A. Ya. Kats' method was used, based on surface and deep functional stimulation of the periodontium, which led to eruption of the 21st tooth.

Child↗

[Observing the tooth. The paths of light in visual and instrumental observation].

The light we observe when we look at a tooth has travelled a long way through the tooth. A large fraction has passed through the dentine. There is also a sideways displacement: the point of entrance into the tooth is about 2 mm away from the point of exit. This implies that tooth color cannot correctly be measured with an instrument employing a single circular window for both illumination and measurement. Visual caries diagnosis of smooth surfaces and with Fiber Optic Trans Illumination (FOTI) is discussed in terms of light paths through the tooth.

Color↗

Delayed tooth eruption in membrane type-1 matrix metalloproteinase deficient mice.

Membrane-type 1 matrix metalloproteinase (MT1-MMP) is expressed highly in mineralizing tissues including bones and teeth. Mice deficient in MT1-MMP (-/-) display severe defects in skeletal development including dwarfism, osteopenia, and craniofacial abnormalities. Death occurs in these mice by about 3 weeks of age. Since MT1-MMP is expressed by the ameloblasts of the enamel organ and by the odontoblasts of the dental papilla, we asked if the developing teeth were adversely affected in the knockout animals. Molars from MT1-MMP -/- mice and controls were examined by histological, X-ray, and SEM analysis at 4, 18-20, and 25 days of postnatal development. At 4 days of development the molars from the -/- mice appeared histologically normal. At 18-20 days of development, the first molars of the -/- mice had apparently normal tooth crowns with normal dentin and enamel; however, the roots were truncated and the teeth had not yet erupted. In contrast to the -/- mice, the first molars of the 18-20-day control animals had erupted. SEM analysis of a -/- first molar and incisor revealed a normal enamel prism pattern. However, X-ray analysis demonstrated that tooth eruption was delayed by approximately 5 days and that the tooth roots were abnormally short in the knockout animals. Since MT1-MMP-deficient mice have been demonstrated to display a generalized increase in bone resorption, these data suggest that inefficient growth of bone surrounding the tooth root complex causes a delay in tooth eruption.

Animals↗

[Determination of tooth length in endodontics].

Determination of the exact tooth length and subsequent working length remains a corner stone of proper endodontic treatment. Up to now, no system has proven to provide the exact location of the apical constriction under all circumstances. Several possibilities of determining tooth length are discussed. Factors influencing the outcome of the different techniques are described. A simple and rather accurate way for calculating tooth length on X-rays is elaborated. Apparently, electronic devices are becoming increasingly accurate, and may become a challenge for the radiographic tooth length determination. Actually, dentists have most of all to rely on X-rays for tooth length determination.

Humans↗

Replantation of a maxillary canine tooth after traumatic avulsion in a dog.

An infrequent traumatic injury in dogs is avulsion of a tooth from its alveolus. The management of the avulsed tooth is complex. This report describes the treatment of a traumatically avulsed maxillary canine tooth in a dog. Replantation and splinting of the tooth was performed. Despite a protracted extraoral time, follow up clinical and radiographic assessment of the tooth indicated successful replantation.

Alveolar Process↗

[The expression and function of Smad7 during human tooth germ development].

OBJECTIVE: To observe the temporal and spatial expression of Smad7 during human tooth germ development and evaluate the effect of Smad7 on tooth germ development. METHODS: The expression of Smad7 and its changes at different stages of human tooth germ were detected by using immunohistochemical staining. RESULTS: Smad7 was expressed at all stages of tooth germ, but the distribution patterns at various stages were different. It indicated that temporal and spatial expressing mode of Smad7 during human tooth germ development was specific, which was similar to that of TGF-beta its signal transducer Smad2/3. CONCLUSION: Smad7 might play an important role in TGF-beta intracellular signaling for modulating the differentiation of ameloblasts and odontoblasts.

Ameloblasts↗

Early and immediately restored and loaded dental implants for single-tooth and partial-arch applications.

PURPOSE: The objective of this consensus committee report was to review the available literature published predominantly in refereed journals to summarize findings, data, and conclusions as they related to reduced healing times and protocols for single-tooth and partial-arch clinical situations. Early loading of dental implants has been defined as restoration of implants in or out of occlusion at least 48 hours after implant placement, but at a shorter time interval than conventional healing. Immediate loading or restoration has been defined as attachment of a restoration in or out of direct occlusal function within 48 hours of surgical placement. MATERIALS AND METHODS: Six articles addressing early loading, with a mixture of single-tooth and partial-arch clinical conditions and including some controlled cohort studies, were reviewed. Immediate loading or restoration of dental implants in single-tooth and partial-arch applications, was extensively reviewed. An attempt was made to isolate and categorize similar case types to discern trends and relevant factors. Variables that were considered included single- or multiple-tooth conditions, immediate or delayed placement in extraction sockets, effect of implant surface and geometry, bone quality, implant stability, surgical technique, occlusal design, effect of cigarette smoking, and stability of results. RESULTS: Combined data from 6 early loading studies on single-tooth and partial-arch applications revealed 1,046 implants with a survival rate of 98.2%. Long-term data for most of the early loading studies were not yet available. Most of the publications on immediate loading or restoration of dental implants were written as case series rather than scientific studies. DISCUSSION AND CONCLUSIONS: In general, most publications indicated that with attention to appropriate factors, implant survival with immediate restoration was comparable to the results with conventional and early loading protocols. It should be recognized that, with few exceptions, these conclusions may be misleading statistical phenomena of the authors, as most publications were written by exceptionally experienced, highly skilled practitioners working under tightly controlled clinical conditions on a relatively small, statistically inconclusive number of implants and patients.

Crowns↗

Comparison of two over-the-counter tooth whitening products using a novel system.

Tooth whitening is one of the most widely accepted esthetic procedures in dentistry. Various treatment options include in-office and prescribed at-home bleaching procedures, over-the-counter bleaching kits, and whitening dentifrices. This study evaluated and compared a 6% hydrogen peroxide tooth bleaching gel delivered on polyethylene film (HP) with an 18% carbamide peroxide brush-applied liquid gel (CP). A total of 59 subjects completed this 2-week, examiner blind, randomized, parallel group study. Both treatments were applied twice daily for 2 weeks according to the manufacturer's instructions. Evaluations for oral safety and Vita tooth shade were conducted by a dental examiner at baseline and 2 weeks after product use. In addition, the ShadeVision System was used to determine changes in Vita shade and L*a*b* values. Based on both the examiner and ShadeVision System assessments, both treatments significantly improved tooth shade. Improvements in Vita tooth shade based on the adjusted mean for HP were 2.64 (P < 0.001) and 2.33 (P < 0.001) for the examiner and ShadeVision System assessments, respectively, compared with improvements of 1.04 (P = .004) and 0.42 (P = 0.029) for CP users, respectively. The difference between treatments was found to be significant for both the examiner (P = .005) and ShadeVision (P = .001) assessments. Findings from the L*a*b* data derived from the ShadeVision System were in agreement with Vita assessments, with significant differences for changes in L*, a*, and b* in favor of HP users (P = .001). In this study, the ShadeVision method of color analysis was relatively easy to use and demonstrated significant differences between 2 OTC whitening products using both Vitapan and L*a*b* means of assessment.

Adult↗

[Physiological tooth migration in hydroxyapatite grafts with bony regeneration. Animal study].

Tooth migration into jaw segments where granular hydroxy apatite had been implanted was studied in rats. To prevent premature contact with the ceramic granules, tooth germs were completely removed in the animals at the age of 10 days. Tooth root contact with the ceramo-osseous complex as a result of physiological tooth migration had deleterious effects. In the light of these findings the implantation of granular hydroxy apatite in the vicinity of tooth roots is not advisable.

Animals↗

[The regulation of tooth eruption].

The aim of the present publication is to provide a broad survey of the current concepts on the regulation of tooth eruption. There is increasing evidence that tooth eruption is a multifactorial process. The bone resorption occlusal to an erupting tooth is probably induced by the occlusal part of the follicle, and allows the tooth to erupt. The occlusal movement it self is likely to be regulated by a localized increase in tissue fluid pressure in the apical area. The bone deposition which is often observed apical to an erupting tooth is more likely to be a reaction to the eruption than a source of eruptive forces.

Bone Resorption↗

Comparative clinical evaluation of two professional tooth-whitening products.

A 2-week study was conducted to compare the tooth-whitening efficacy of two 10% carbamide peroxide products: Colgate Platinum Professional Toothwhitening System and Rembrandt Lighten Bleaching Gel. Fifty subjects were divided into two groups and assigned a product to use for 2 weeks. Change in tooth color was measured by reflectance spectroscopy at the initiation of study, at 1 week, and at 2 weeks into the study. Color change was calculated using the color-difference equation established by the Commission International de L'Eclairage. Results showed that Colgate Platinum was 62% more effective at tooth whitening after 1 week and 83% more effective after 2 weeks of treatment vs Rembrandt. At the termination of the study, the mean color difference (deltaE) for Colgate Platinum was 4.29 and 2.34 for Rembrandt. Statistical analysis demonstrated that the Colgate product is significantly superior at increasing tooth whiteness, increasing tooth lightness, reducing redness, and reducing yellowness. In this study, no adverse reactions were noted on clinical examination and none were reported by panelists with normal healthy dentition.

Analysis of Variance↗

Rotary reduction, enamel microabrasion, and dental bleaching for tooth color improvement.

Tooth color and shade can have an important influence on a person's appearance. Brown and white enamel dysmineralization defects, white hypocalcification lesions, and natural variations in tooth shading can detract from an otherwise attractive smile. Bonded facial composite resins, porcelain veneers, or full-coverage restorations can be used for color correction. A more conservative and less expensive approach is to eliminate or reduce the discoloration. In select cases this can be done without removing significant tooth structure and without placing restorative material to mask the tooth. This article describes a combination of "microreduction," microabrasion, and dental bleaching for tooth color correction that has worked well for certain patients. The method is easily performed, conservative, inexpensive, and requires minimal subsequent maintenance.

Adolescent↗

Tooth auto-transplantation with double periodontal ligament stimulation to replace periodontally compromised teeth.

BACKGROUND: The healing process of autotransplantation puts 2 different tissues in competition: the ligament on the root surface and the bone tissue of the alveolus. This study shows the effects of a protocol with 2 surgical stages, which promote ligament repair, inhibit adhesion between bone and dental root, and reduce the occurrence of the ankylosis-root resorption phenomenon. METHODS: Forty-three patients, 33 to 73 years old, received 47 transplantations of mature teeth (including retained teeth) during a 5-year period. During the first surgical step, the transplanted tooth is extracted, measured, immediately replaced in its origin site, and maintained with an original suture technique. The alveolus to which the tooth will be transplanted is adapted after extraction of the periodontally compromised tooth. The second surgery occurs at day 14, when regeneration of periodontal ligament (PDL) is at a maximum (first stimulation). The tooth is transplanted in its new alveolus and retained using the same suture technique to avoid a rigid splint and to create mechanical stimulation of the PDL (second stimulation). RESULTS: The results were 95.75% positive with normal PDL, with a 4.25% failure rate (transplant loss) and no ankylosis. Mean probing reduction was 8.37 +/- 3.0 mm. Mean radiographic bone gain was 7.73 +/- 4.32 mm. CONCLUSIONS: This study suggests that auto-transplantation with double PDL stimulation can be a viable treatment in clinical practice, especially to replace teeth with large periodontal lesions, deep furcation defects, and/or root fractures. This study shows the high potential of stimulated PDL to regenerate alveolar bone and periodontal structures in severe destruction sites.

Adult↗

The effect of tooth position on the image of unerupted canines on panoramic radiographs.

The purpose of this study was to evaluate whether panoramic tomograms, which are routinely used in orthodontic practice, can provide adequate information to localize an impacted canine. The effect of changes in position and inclination of an impacted canine on orthopantomograms was investigated in an experimental set-up. An upper canine was removed from a human skull and replaced in a positioning system, enabling simulated positional variations in impactions. In comparison with the image of a contralateral well-aligned canine, the length of the impacted tooth always decreased or remained unchanged, whereas the tooth width increased or remained unchanged. The angulation of the image was unaffected by varying the position of the impacted canine, but altered when the inclination of the tooth in a sagittal or frontal direction was changed. If there was any transversal shift of the impacted canine on the orthopantomogram, it was always towards the mid-sagittal plane. The curvature of the tooth increased after dorsal inclination and decreased after ventral inclination (in comparison with the contralateral well-aligned canine).

Cephalometry↗

Tooth eruption: evidence for the central role of the dental follicle.

The roles of the gubernaculum dentis, root formation, tooth crown and dental follicle in prefunctional eruption of a mandibular premolar have been studied in nine beagle dogs by radiographic and histologic evaluations of the effects of surgical ablation or removal of these structures on tooth eruption. The dental follicle was the only one of these structures required for the coordinated enlargement of the eruption pathway and formation of bone in the base of the bony crypt, the radiographic and histologic hallmarks of tooth eruption. These data, together with the topographic relationships of the dental follicle to areas of localized bone resorption and formation, are interpreted to mean that the dental follicle may influence, if not coordinate, these processes in tooth eruption.

Alveolar Process↗