Lateral incisor Auto Transplantation with Autogenous Bone Graft in Multiple Embedded Teeth Patient: A Case Report

Abstract

Tooth autotransplantation with closed apex donor tooth is possible if the donor tooth is proper for the recipient site. The donor tooth need to have root canal treatment 2 weeks after transplantation to prevent inflammatory root resorption. In case of the recipient site’s bone is deficiency, alveolar bone augmentation prior or simultaneous with tooth transplantation are the choice of treatment. This case report referred to 13 years old Thai boy who had embedded teeth 21, 22, 23 and 24. Since last 2 years, 21 and 22 were treated by artificial eruption while 21 could erupt in normal position but 22, 23, and 24 still unerupted. The mesio-distal space between 21 and 25 was not enough for 22, 23, and 24 therefore autotransplantation of 22, artificial eruption of 23 and surgical removal of 24 were planned. In the operation, 22 was complete root formation with insufficient bone in the recipient area due to severe buccal cortical bone loss from surgical removal of 24. The cortico-cancellous bone harvested from chin were prepared for simultaneous augmentation. The root canal treatment for donor tooth 22 was performed within 2 weeks after transplantation. 1 year follow up, 22 was in good position with adequate bone support and 23 could erupt in normal position.  The factors affected successful tooth autotransplantation and the treatment plan for young patient with multiple embedded teeth were discussed.