Autotransplantation of Premolars to the Anterior Maxilla: A Long-Term Retrospective Cohort Study of Survival, Success, Esthetic, and Patient-Reported Outcome With up to 38-Year Follow-Up.

Autor: Akhlef Y; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.; Department of Oral and Maxillofacial Surgery, Zealand University Hospital, Zealand, Denmark., Hosseini M; Research Area Oral Rehabilitation, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Schwartz O; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark., Andreasen JO; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark., Gerds TA; Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Jensen SS; Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.; Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Dental traumatology : official publication of International Association for Dental Traumatology [Dent Traumatol] 2024 Dec 11. Date of Electronic Publication: 2024 Dec 11.
DOI: 10.1111/edt.13025
Abstrakt: Background/aim: Autotransplantation is a well-documented procedure for replacing missing teeth in the anterior maxilla. This retrospective study aims to evaluate long-term survival rate, success rate as well as esthetics and patient-reported outcome of premolars autotransplanted to the anterior maxilla and secondarily to identify potential prognostic factors for survival, success, esthetic, and biological complications.
Material and Methods: One hundred and twenty-two patients with 153 transplants were assessed on survival rate and potential prognostic factors, while 50 patients with 61 autotransplanted premolars underwent clinical, radiographic, and esthetic assessment. Clinical and radiographic parameters were recorded. Esthetic outcomes were evaluated using a comprehensive score system comparing transplanted teeth to neighboring tooth. All patients filled in a questionnaire about the esthetic outcome of the treatment.
Results: The survival rate of transplants after 16-38 years was 76%, with the majority showing no periodontal complications (95%). Radiographically, 46% of transplanted premolars showed no signs of pathosis. Ankylosis and inflammatory resorption were observed in 19% and 16%, respectively. Prognostic factors such as donor tooth type and root stage did not significantly affect transplant survival. Premolars transplanted at an immature stage had a significant lower risk of ankylosis, compared to more mature transplants. Esthetically, 72% of the transplants matched their neighboring teeth, and taking the biological success into consideration an overall success rate was 57.3%. In total, 71% of all patients were esthetically satisfied with their autotransplant, 18% were fairly satisfied, and 11% were dissatisfied.
Conclusions: The transplants demonstrated high survival rate, albeit with biological complications such as ankylosis and inflammatory root resorption. Developmental stage of the root at the time of transplantation had a significant influence on ankylosis of transplanted teeth. Esthetic outcomes were generally satisfactory, although challenges were noted with certain restoration types and donor tooth selections. Overall, the majority of patients expressed satisfaction with their autotransplanted teeth.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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