autotransplantation of impacted maxillary canines into

196 | The International Journal of Esthetic Dentistry | Volume 15 | Number 2 | Summer 2020

CASE REPORT

Autotransplantation of impacted maxillary canines into surgically modified sockets and orthodontic treatment: a 4-year follow-up case report

Juan Zufía, DDS, MSc

Private Practice, Madrid, Spain

Francesc Abella, DDS, PhD

Department of Endodontics and Restorative Dentistry, Universitat Internacional de

Catalunya, Sant Cugat del Vallès, Barcelona, Spain

Ramon Gómez-Meda, DDS, MSc

Private Practice, Ponferrada, Spain

Helena Blanco, DDS, MSc

Private Practice, Madrid, Spain

Miguel Roig, DDS, PhD

Department of Aesthetic and Restorative Dentistry, Universitat Internacional de

Catalunya, Sant Cugat del Vallès, Barcelona, Spain

Correspondence to: Dr Francesc Abella

Universitat Internacional de Catalunya, Dentistry Faculty, C/Josep Trueta s/n, 08195 Sant Cugat del Vallès, Spain;

Tel: + 34 504 2000, Fax: +34 504 2031; Email: e-mail: [email protected]

ZUFIA ET AL

197197

Abstract

The permanent maxillary canine is the second most

frequently impacted or displaced tooth. The standard

treatment for an impacted canine includes, among

other things, surgical exposure and orthodontic align-

ment. Surgical techniques for this procedure vary de-

pending on whether the tooth is labially or palatally

impacted, while orthodontic techniques vary accord-

ing to clinical judgment and experience. Autotrans-

plantation is a treatment alternative for impacted ca-

nines with complete root formation. The success of

tooth transplantation depends on the vitality of the

periodontal ligament (PDL) attached to the donor

tooth, and its viability decreases when it is exposed

extraorally. This article reports on maxillary canine au-

totransplantations combined with connective tissue

grafts (CTGs) and orthodontics. The recipient me-

siodistal space was created orthodontically and the

recipient socket was prepared using dental implant

drills. Following transplantation, bone defects were

grafted using guided bone regeneration (GBR). At

4 years post-transplantation, the soft tissue level was

stable and periapical radiographs showed a practically

normal contour of the alveolar crest around teeth 13

and 23. The two permanent canines presented no

root resorption and ankylosis, and no signs of inflam-

mation or bleeding were observed. The procedure

used in this case report demonstrates that canine

transplantation combined with GBR, plastic surgery

procedures, and orthodontic treatment may yield ac-

ceptable and predictable esthetic results.

(Int J Esthet Dent 2020;15:196–210)

197The International Journal of Esthetic Dentistry | Volume 15 | Number 2 | Summer 2020 The International Journal of Esthetic Dentistry | Volume 15 | Number 2 | Summer 2020 ||

CASE REPORT


or ectopic site and the creation or modifica-

tion of a socket at the recipient site. This is

followed by replantation of the tooth into the

ideal three-dimensional (3D) position within

the alveolus.

The prognosis of autotransplanted teeth

is determined by several conditions includ-

ing patient age and gender, developmental

stage and root anatomy of the donor tooth,

adequate alveolar bone support, atraumatic

surgical technique, adaptation of the donor

tooth to the recipient site, method of fixa-

tion/stabilization, and postoperative care. It

goes without saying that the clinician’s ex-

perience is equally essential.10 However, the

most critical factor for long-term success is

to maintain healthy and viable periodontal

ligament (PDL) cells on the root surface.11

Implants and removable or fixed partial den-

tures can also offer good alternatives, but

unlike natural teeth that have a normal PDL

and a natural esthetic, the use of artificial

material is a drawback.12 Autotransplants not

only maintain alveolar bone, they also trump

implants in that they allow proprioception

during function, and can be performed in

growing patients.13

The present case report presents a 40

year-old female. Teeth 53 and 63 have mo-

bility type II and impacted maxillary canines.

The treatment plan called for a series of

periodontal surgeries combined with ortho-

dontics and autotransplantation of teeth 13

and 23. The treatment lasted 1 year and

8 months, with the last clinical and radio-

graphic control carried out 4 years post-

treatment. The procedure described in this

article aimed to demonstrate that autotrans-

plantation is also a reliable alternative in cas-

es of impacted canines.

Case presentation

A 40-year-old female presented at the clinic

complaining of increased mobility in the

maxillary primary canines and of the un-

Introduction

According to clinical and radiographic as-

sessment, impacted teeth are described as

those that either erupt late or are not pre-

dicted to erupt completely. The incidence

of tooth impaction has been reported to

vary from 5.6% to 18.8% of the population.1

After the third molar, the second most fre-

quently impacted tooth is the permanent

maxillary canine, the impaction of which

has a prevalence of some 2% in the general

population.2 Of these, 85% are palatally im-

pacted, and 15% are labially impacted.3 The

maxillary canine performs a vital role in fa-

cial appearance, dental esthetics, lip sup-

port, arch development, functional occlu-

sion, and phonetics.4 In contrast, the

incidence of impacted mandibular canines

does not exceed 0.5%.5

The main treatment options available for

impacted canines include the wait-and-see

approach, interception, surgical exposure

(with or without orthodontic alignment), au-

totransplantation, and extraction. The two

most common methods used to bring pala-

tally impacted canines into occlusion con-

sist of: 1) surgically exposing the teeth and

allowing them to erupt naturally during early

or late mixed dentition; and 2) surgically ex-

posing the teeth and bonding an attach-

ment to move the tooth using orthodontic

forces.6,7

Orthodontic appliance treatment is some-

times hazardous or impractical, especially

when impacted maxillary canines are in

oblique/horizontal positions.8 Moreover, or-

thodontic treatment is not always accepted

by patients due to the 2- to 3-year treatment

time, and factors such as the position of the

canines as well as esthetic and economic

considerations. In such cases, if there is suffi-

cient space for the transplanted tooth, auto-

transplantation might provide a treatment al-

ternative.9 This process entails atraumatic

surgical removal of a tooth from its impacted

ZUFIA ET AL

199The International Journal of Esthetic Dentistry | Volume 15 | Number 2 | Summer 2020 |

in the adjacent teeth (Fig 2a). It was decided

to perform cone beam computed tomogra-

phy (CBCT) to find out the exact position of

the permanent canines and to ascertain

whether autotransplantation of these teeth

was viable for replacing the primary canines.

After evaluating the different CBCT slices

(sagittal, coronal, and axial views), both ca-

nines were observed to be palatally placed,

making an autotransplantation technique

perfectly possible (Fig 2b to d). Due to the

patient’s age, and because orthodontic

treatment is prolonged, the surgical expo-

sure technique followed by orthodontic

traction was ruled out. The patient was fully

informed that in the event of autotransplan-

tation failure, the definitive treatment would

consist of either an implant or a fixed dental

prosthesis.

sightly aspect of her anterior teeth. At the

first appointment, the patient’s medical and

dental records showed no history of sys-

temic disease or drug allergies, and that she

was taking no medication. Clinical and ra-

diological testing to exclude pathological

processes revealed no contraindications for

dental treatment.

The pretreatment records showed nor-

mal vertical facial proportions, a straight

profile, and good facial symmetry. The initial

intraoral photograph confirmed that the

maxillary left and right primary canines were

retained and restored with composite resin

(Fig 1). Teeth 12 and 22 presented Miller

Class III gingival recessions, although anoth-

er clinician had previously attempted to cor-

rect them by performing two free epithelial

grafts. As seen in Figure 1, the result was un-

successful and unsightly. Analysis of the

dental casts disclosed a Class III molar rela-

tionship tendency on both sides. The maxil-

lary overjet was 2.0 mm and the overbite

4.0 mm, and the patient had no crossbites.

In addition, the upper midline shifted to the

left by 1 mm.

The panoramic radiograph showed that

both maxillary canines were impacted with-

out producing any apparent root resorption

Fig 1 Preoperative

view showing the

presence of axillary

primary canines and

Miller Class III gingival

recessions in teeth 12

and 22.

Fig 2 Pretreatment radiographic study. (a) Panoramic radiograph. (b) Coronal view of the cone beam computed tomography (CBCT) image.

(c and d) Axial and sagittal views revealing the palatal position of both maxillary permanent canines.

dc

ba

CASE REPORT


Fig 3 Root coverage surgery on teeth 12 and 22. (a) Connective tissue graft on tooth 12 by means of a coronally

advanced tunnel flap (CATF) technique. (b) Same surgical procedure performed on tooth 22. (c) Final situation AA

immediately after the two connective tissue grafts. (d) Clinical appearance at 3 weeks post periodontal surgery.

a b

c d

Fig 4 (a) Multibracket orthodontic treatment started at 3 months postsurgery. (b) Careful extraction of the

maxillary right primary canine. (c) The recipient site postextraction. (d) Surgical exposure of the maxillary right

permanent canine.

a

c

b

d

ZUFIA ET AL


formed gently with an excavator with the

aim of avoiding damage to the healthy PDL

remnants on the root (Fig 4d). When suffi-

cient bone was removed, the impacted ca-

nines were delicately elevated from their

sockets. Once the extractions had been

completed, the previously calculated digital

measurements (root length, total tooth

length, and diameter) were checked quickly

with a periodontal probe, and the teeth

were placed in saline solution until they

were transplanted. The curvature of the root

of the permanent canines meant that both

roots had to be shortened to better accom-

modate them in the recipient sites.

At this point, the work was divided into

two parts: one clinician prepared the new

sockets so that the teeth could be placed in

their correct anatomical position (Fig 5),

while another performed the endodontic

treatments and sealed the root-end cavities

with an apical plug using white root repair

material (ProRoot MTATT ; Dentsply Sirona) (Fig

6). Endodontic treatments and apical retro-

fillings were performed to avoid contamina-

tion of the bone substitute used to regener-

ate the cavities resulting from the extraction

of the canines. These cavities were suffi-

ciently large to facilitate the atraumatic ex-

traction of the impacted canines.

The recipient sites were modified by a

surgical implantology set (Camlog Biotech-

nologies). The entire milling sequence was

used up to the 6-mm-diameter drill, which

was moved from palatine to buccal with an

oscillating movement to form an ovoid re-

cipient capable of harboring the root of

both permanent canines. Care was taken to

preserve the entire buccal cortical plate.

The height of the palatal cortical plate was

preserved only in the area 2 mm coronal to

the right maxillary canine, and disappeared

completely during the site preparation to

house tooth 23. Given the amount of bone

removed in the palatal alveolar process, an

allograft human bone (Barcelona Tissue

Treatment objectives

The objectives were to obtain root cover-

age of teeth 12 and 22 and replace the pri-

mary canines with the permanent ones by

means of autotransplant surgery. At the

same time, the esthetics of the anterior

teeth would be improved and the soft tissue

profile maintained.

Treatment progress

The first phase consisted of performing root

coverage surgery on teeth 12 and 22

through two connective tissue grafts (CTGs)

by means of a coronally advanced tunnel

flap (CATF) technique (Fig 3).AA After 3 months

of healing, multibracket orthodontic treat-

ment was started (Dolphin Aesthetic SLB

MBT 022; Ortolan) to align and level all the

teeth and to open up the space in the pri-

mary canine area (previously measured in

the CBCT) where the permanent canines

would be seated in an ideal 3D position (Fig

4a). The DICOM (Digital Imaging and Com-

munications in Medicine) files obtained

from the CBCT were used to measure the

length, height, and width of the permanent

canines. The distance between the trans-

planted canines and the neighboring teeth

was digitally calculated at about 2 mm to

provide sufficient space for the biologic

width and to achieve an optimum esthetic

outcome. The first phase of the orthodontic

treatment lasted 12 months.

After completing the first phase of the

treatment, autotransplantation surgery was

performed. First, the primary canines were

extracted carefully so as not to damage the

buccal cortical plate at any time (Fig 4b and

c). Bone covering the impacted teeth was

gradually demarcated using a piezoelectric

handpiece under abundant water-cooling

irrigation until a thin layer of bone was left

close to the cementum and enamel. Final

elevation of the bone as a block was per-

CASE REPORT


Fig 5 Preparation of the alveolar bed to receive the donor tooth. (a) Initial dimensions of the recipient socket. (b)

Modification of the recipient socket using dental implant drills. (c) The recipient site after the surgical preparation.

Fig 6 Apical preparation of the permanent canine. (a) Comparison of dimensions between the permanent

maxillary canine and the primary canine. (b) Enlargement and resection of the apical 3 mm. (c) Endodontic

treatment completed extraorally. (d) Apical plug with white ProRoot MTATT . (e) Donor tooth coated with enamel

matrix proteins before placement in the recipient socket.

ca

d

b

e

a

b c

ZUFIA ET AL


Fig 7� Placement procedure of the right maxillary canine. (a) New connective tissue graft placed to stabilize the

gingival margin. (b) Try-in of the donor tooth. (c and d) Allograft human bone inserted between the root and the

palatine mucosa. (e) Bioresorbable membrane placed between the bone substitute and the flap. (f) Final position of

the donor tooth and suture.

Bank) between the root and the palatine

mucosa was placed. Then, a bioresorbable

membrane (OsteoBiol Evolution mem-

brane; Tecnoss) was inserted between the

bone substitute and the flap (Figs 7 and 8).

Before placing the permanent canines

on the modified recipient sites, they were

coated with enamel matrix proteins (Em-

dogain; Straumann), which facilitate the re-

generation of possible injured periodontal

tissue. At the same time, two new CTGs

were placed to stabilize the gingival margin

before the final suture. The upper archwire

system was maintained in order to passively

hold the permanent canines, which were

anchored to the arch by two brackets. The

canines were also splinted in the palatal sur-

face with a segment wire (0.012 nickel-tita-

nium) and composite resin for 30 days

(Fig 9a). In both canines, the time between

removal and placement of the impacted

tooth in the new socket did not exceed

25 min. In addition, to avoid canine-guided

occlusion during healing, occlusal lifts were

temporary placed on the maxillary incisors,

second premolars, and first molars (Fig 9b

and c).

After 1 month, new CTGs were per-

formed in both canine areas to finish re-

moving the epithelial remains from previous

surgeries (Figs 10 and 11). Advantage was

taken of these grafts to improve the bio-

types, stabilize the margins, and treat the

postsurgical residual recessions. The ortho-

b

d

f

a

c

e

CASE REPORT


Fig 8 lacement procedure of the left maxillary canine. (a) Palatal flap elevated from left canine region. (b) Surgical

exposure of the donor tooth. (c) Modification of the socket to allow the permanent canine to be replanted. (d)

Try-in of the donor tooth. (e) Allograft at the donor site. (f) Adjustment of the membrane to the bone defect.

ba

dc

fe

Fig 9 Final position of the autotransplanted teeth

anchored to the arch by two brackets. (a) Buccal view.

(b) Palatal view. (c) Aspect of healing at 30 days.

c

a b

ZUFIA ET AL


b

d

f

a

c

e

g

Fig 10 Connective tissue graft performed on the right

maxillary canine area. (a and b) Measurement of the

area to be grafted. (c and d) Removal of epithelial

remains from previous surgeries. (e) Obtaining the

connective tissue graft. (f) Tunnel connective tissue

graft. (g) Final suture.

dontic appliances were completely re-

moved 6 months after autotransplant sur-

gery. After the healing of these third

connective grafts, the case was terminated

by performing an external bleaching as well

as direct composite restorations on teeth 12

and 22 to correct the wear and to shape the

anatomy of the teeth (Fig 12). The occlusion

was stabilized using a lingual bonded retain-

er (from teeth 33 to 43) and an upper Essix

retainer. The total treatment time was 1 year

and 8 months.

Four years after the transplantation, the

soft tissue level was stable, and periapical

radiographs showed a practically normal

contour of the alveolar crest around teeth

13 and 23 (Fig 13). No signs of inflammation

or bleeding were observed.

CASE REPORT


Fig 11 Connective tissue graft performed in the left

maxillary canine area. (a) Final size of the connective

tissue graft. (b) Stabilization of the connective tissue

graft. (c) Buccal aspect of the anterior teeth immediate-

ly after the connective tissue grafts.

a

c

b

Fig 12 External bleaching and direct composite restorations on teeth 12 and 22. (a and b) Occlusal adjustment in

eccentric movements. (c) Palatal view of the transplanted canines (d and e) Radiographic views.

a

c

b

d e

ZUFIA ET AL


with an open apex, are similar to those of

dental implants.13,19 When a donor tooth has

incompletely formed roots, pulp revascular-

ization allows for pulp healing and continual

root development. Thus, in most cases, no

endodontic treatment is required, allowing

for short treatment times, few pulpoperiapi-

cal problems, and almost no root frac-

tures.20 These advantages partly account for

the high success rates of autotransplants of

immature teeth, a procedure particularly in-

dicated in growing patients.21,22

Recent studies have also reported high

success rates in donor teeth with a closed

apex.11,23,24 In their meta-analysis of auto-

transplantation of maxillary canines, Grisar

et al15 showed an 87.5% outcome rate at 2 to

5 years follow-up, and 88.2% at over 5 years

follow-up. The pulp of a completely mature

tooth cannot generally regenerate. Hence,

if the tooth to be transplanted is accessible,

endodontic treatment should be completed

before transplantation;25 otherwise, the

endodontic treatment should be initiated

2 weeks after transplantation to avoid an in-

flammatory resorption from the infected

root canal.13 Endodontic treatment can also

be performed during the same surgical pro-

cedure (but was not done in this case) when

Discussion

The management of impacted canines is

important in terms of esthetics and func-

tion.14 Clinicians should plan treatments that

are in the best interests of the patient; there-

fore, they need to be knowledgeable about

the range of treatment options. Although

transplantation is not usually first-line treat-

ment for patients with impacted canines,

this procedure presents a mean survival of

14.5 years for 83% of transplants, making it a

viable option.8

Clinicians should take into account two

main factors when considering autotrans-

plantation for impacted maxillary canines: 1)

the anatomical complexity involved in ac-

commodating the canine with orthodontic

traction; and 2) the patient’s willingness to

wear orthodontic appliances or undergo

long-term treatment.15 Other factors to con-

sider include the available space in the arch

for autotransplantation, the prognosis of the

primary canines, the possibility of perform-

ing an atraumatic extraction while maintain-

ing the viability of the PDL, and the clini-

cian’s experience.16-18

The longevity and prognosis of tooth au-

totransplantation, particularly donor teeth

Fig 13 Follow-up at 4-years posttreatment.

CASE REPORT


Despite the successful result of this case,

the autotransplantation technique may

present complications, such as root resorp-

tion and attachment loss, which could even

result in tooth loss, making the treatment

outcome difficult to predict.

Conclusions

Autotransplantation combined with ortho-

dontic treatment provides a viable treatment

alternative for impacted canines. The most

important factor for success is that a vital

(and functional) PDL must be attached to

the autotransplanted tooth. Necrosis or me-

chanical loss of the PDL leads to root re-

sorption (ankylosis or inflammatory resorp-

tion) or epithelial downgrowth. Even in

cases with extensive buccal or palatal/lin-

gual alveolar bone atrophy, promising and

optimally functional outcomes can be ob-

tained with the use of GBR. In this case,

modified surgical techniques allowed for a

minimally traumatic removal of the donor

teeth. Finally, it should be noted that CBCT

imaging is mandatory to develop a success-

ful treatment plan.

Disclaimer

The authors declare that there are no con-

flicts of interest.

longer splinting periods are estimated. As

initial primary stability is crucial to the suc-

cess of autotransplantation,26 additional

damage to the PDL was avoided by per-

forming premature endodontic treatment.

The treatment was not postponed, which

would have jeopardized the success of the

guided bone regeneration (GBR) in an in-

fected root canal.

To increase the success rate of tooth au-

totransplantation and make it more predict-

able, it is necessary to be meticulous re-

garding the selection criteria, and to assess

in detail the viability of the donor tooth. In

this sense, low-dose CBCT is the more suit-

able technology for planning the surgical

feasibility and the optimal 3D position of the

donor tooth in the new socket.27,28 From the

CBCT files, computer-aided designed

3D-printed replicas of the donor tooth can

be obtained, although they were not used in

this case. Tooth replica acts as a surgical

guide; provides individualized bone adapt-

ability; and reduces extra-alveolar time for

the donor tooth, thus lowering the risk of

ankylosis.29,30

On the other hand, the treatment of gin-

gival recessions through plastic surgery pro-

cedures is both functionally and esthetically

essential, particularly in anterior teeth.31 The

main objective of these procedures is to

achieve complete root coverage, while im-

proving esthetics, hypersensitivity, and pre-

vention of caries and noncarious cervical

lesions. In this case, a series of periodontal

surgeries were performed, combined at dif-

ferent times with orthodontic treatment.

Various systematic reviews, including Cairo

et al32 and Sanz and Simion,33 have con-

firmed that the gold standard for root cover-

age consists of a coronally advanced flap

combined with a CTG. It has been shown

that the use of a CTG allows for a more sta-

ble coronal advance and less soft tissue

shrinkage. It also leads to increases in kerati-

nized tissue.34

ZUFIA ET AL


References

1. Fardi A, Kondylidou-Sidira A,

Bachour Z, Parisis N, Tsirlis A.

Incidence of impacted and super-

numerary teeth – a radiographic

study in a North Greek population.

Med Oral Patol Oral Cir Bucal

2011;16:e56–e61.

2. Ericson S, Kurol J. Radiograph-

ic assessment of maxillary canine

eruption in children with clinical

signs of eruption disturbance. Eur J

Orthod 1986;8:133–140.

3. Ericson S, Kurol J. Radiographic

examination of ectopically erupting

maxillary canines. Am J Orthod

Dentofacial Orthop 1987;91:

483–492.

4. Bishara SE. Impacted maxillary

canines: a review. Am J Orthod

Dentofacial Orthop 1992;101:

159–171.

5. Fardi A, Kondylidou-Sidira A,

Bachour Z, Parisis N, Tsirlis A.

Incidence of impacted and super-

numerary teeth – a radiographic

study in a North Greek population.

Med Oral Patol Oral Cir Bucal

2011;16:e56–e61.

6. Kokich VG, Mathews DA. Impact-

ed teeth: surgical and orthodontic

considerations. In: McNamara JA,

Brudon WL, Kokich VG (eds). Ortho-

dontics and Dentofacial Orthope-

dics. Ann Arbor, Needham Press,

2001:395–422.

7. Schmidt AD, Kokich VG. Peri-

odontal response to early uncov-

ering, autonomous eruption, and

orthodontic alignment of palatally

impacted maxillary canines. Am

J Orthod Dentofacial Orthop

2007;131:449–455.

8. Patel S, Fanshawe T, Bister D,

Cobourne MT. Survival and success

of maxillary canine autotransplan-

tation: a retrospective investigation.

Eur J Orthod 2011;33:

298–304.

9. Kallu R, Vinckier F, Politis C,

Mwalili S, Willems G. Tooth trans-

plantations: a descriptive retrospec-

tive study. Int J Oral Maxillofac Surg

2005;34:745–755.

10. Almpani K, Papageorgiou SN,

Papadopoulos MA. Autotransplanta-

tion of teeth in humans: a system-

atic review and meta-analysis. Clin

Oral Investig 2015;19:1157–1179.

11. Sugai T, Yohizawa M, Kobayashi

T, et al. Clinical study on prognostic

factors for autotransplantation of

teeth with complete root forma-

tion. Int J Oral Maxillofac Surg

2010;39:1193–1203.

12. Kafourou V, Tong HJ, Day P, PP

Houghton N, Spencer RJ, Duggal

M. Outcomes and prognostic

factors that influence the success

of tooth autotransplantation in

children and adolescents. Dent

Traumatol 2017;33:393–399.

13. Tsukiboshi M. Autotransplan-

tation of teeth: requirements for

predictable success. Dent Trauma-

tol 2002;18:157–180.

14. Bedoya MM, Park JH. A review

of the diagnosis and management

of impacted maxillary canines. J Am

Dent Assoc 2009;140:1485–1493.

15. Grisar K, Chaabouni D, Romero

LPG, Vandendriessche T, Politis C,

Jacobs R. Autogenous transalveolar

transplantation of maxillary canines:

a systematic review and meta-anal-

ysis. Eur J Orthod 2018;40:

608–616.

16. McSherry P. The ectopic max-

illary canine: a review. Br J Orthod

1998;25:209–216.

17. Thomas S, Turner S R, San-

dy JR. Autotransplantation of

teeth: Is there a role? Br J Orthod

1998;25:275–282.

18. Kallu R, Vincker F, Politis C,

Mwalili S, Willems G. Tooth trans-

plantations: a descriptive retrospec-

tive study. Int J Oral Maxillofac Surg

2005;34:745–755.

19. Chung WC, Tu YK, Lin YH, Lu

HK. Outcomes of autotransplanted

teeth with complete root for-

mation: a systematic review and

meta-analysis. J Clin Periodontol

2014;41:412–423.

20. Rohof ECM, Kerdijk W, Jansma

J, Livas C, Ren Y. Autotransplanta-

tion of teeth with incomplete root

formation: a systematic review and

meta-analysis. Clin Oral Investig

2018;22:1613–1624.

21. Czochrowska EM, Stenvik A,

Bjercke B, Zachrisson BU. Outcome

of tooth transplantation: survival

and success rates 17-41 years post-

treatment. Am J Orthod Dentofacial

Orthop 2002;121:110–119.

22. Mejàre B, Wannfors K, Jansson

L. A prospective study on transplan-

tation of third molars with complete

root formation. Oral Surg Oral Med

Oral Pathol Oral Radiol Endod

2004;97:231–238.

23. Bae JH, Choi YH, Cho BH,

Kim YK, Kim SG. Autotransplanta-

tion of teeth with complete root

formation: a case series. J Endod

2010;36:1422–1426.

24. Yu HJ, Jia P,PP Lv Z, Qiu LL LX.

Autotransplantation of third molars

with completely formed roots into

surgically created sockets and fresh

extraction sockets: a 10-year com-

parative study. Int J Oral Maxillofac

Surg 2017;46:531–538.

25. Zufía J, Abella F, Trebol I, Gó-

mez-Meda R. Autotransplantation of

mandibular third molar with buccal

cortical plate to replace vertical-

ly fractured mandibular second

molar: a novel technique. J Endod

2017;43:1574–1578.

26. Kim E, Jung JY, Cha IH, Kum KY,

Lee SJ. Evaluation of the prognosis

and causes of failure in 182 cases of

autogenous tooth transplantation.

Oral Surg Oral Med Oral Pathol

2005;100:112–119.

27. Ashkenazi M, Shashua D, Kegen

S, Nuni E, Duggal M, Shuster A.

Computerized three-dimensional

CASE REPORT


design for accurate orienting and

dimensioning artificial dental socket

for tooth autotransplantation. Quin-

tessence Int 2018;49:663–671.

28. EzEldeen M, Stratis A, Coucke

W, Codari M, Politis C, Jacobs R. As

low dose as sufficient quality: opti-

mization of cone-beam computed

tomographic scanning protocol for

tooth autotransplantation planning

and follow-up in children. J Endod

2017;43:210–217.

29. Verweij JP, Moin DP A, Mensink G,

Nijkamp P, Wismeijer D, van MerkerP -

steyn JP. Autotransplantation of pre-

molars with a 3-dimensional printed

titanium replica of the donor tooth

functioning as a surgical guide:

proof of concept. J Oral Maxillofac

Surg 2016;74:1114–1119.

30. Strbac GD, Schnappauf A,

Giannis K, Bertl MH, Moritz A, Ulm

C. Guided autotransplantation of

teeth: a novel method using virtual-

ly planned 3-dimensional templates.

J Endod 2016;42:1844–1850.

31. Nieri M, Pini Prato GP, Giani M, P

Magnani N, Pagliaro U, Rotundo

R. Patient perceptions of buccal

gingival recessions and requests

for treatment. J Clin Periodontol

2013;40:707–712.

32. Cairo F, Nieri M, Pagliaro U.

Efficacy of periodontal plastic

surgery procedures in the treatment

of localized gingival recessions. A

systematic review. J Clin Periodon-

tol 2014;41:S44–S62.

33. Sanz M, Simion M. Surgical

techniques on periodontal plastic

surgery and soft tissue regenera-

tion: Consensus report of Group 3

of the 10th European Workshop on

Periodontology. J Clin Periodontol

2014;41:S92–S97.

34. Cortellini P, Tonetti M, BaldiP

C, et al. Does placement of a

connective tissue graft improve the

outcomes of a coronally advanced

flap for coverage of single gingival

recessions in upper anterior teeth?

A multi-centre, randomized,

double-blind, clinical trial. J Clin

Periodontol 2009;36:68–79.

autotransplantation of impacted maxillary canines into

Documents