One also speaks of an autogenous tooth transposition or tooth transplantation, if one transplants (transfers) an autogenous (originated from the body itself) (synonym: autologous = transplantation: donor and recipient are the same/patient’s own) tooth through a surgical procedure to the place of a recently extracted (removed) tooth. If the tooth has not yet completed root growth, i.e., is still developing and has not yet erupted into the oral cavity, therefore a tooth germ, it is accordingly a tooth germ transposition or tooth germ transplant.
Indications (areas of application)
This surgical method can be used, for example, in rare cases to replace a six- or twelve-year-old molar that is not worth preserving with a wisdom tooth or wisdom tooth germ. The procedure can prevent a gap in the dental arch in the case of the six-year molar, and a shortened row of teeth in the case of the twelve-year molar.
Before the operation
Clinical findings include measuring the gap that will accommodate the tooth to be transplanted. Radiographic findings (OPG, dental film, bite record) complement the clinical findings. In addition to the general risks of tooth extraction (tooth removal), the possible loss of the transplanted tooth and possible infection of the graft bed must be pointed out in advance.
The surgical procedure
- Exposure of the impacted and/or displaced tooth.
- If root growth is complete: root canal filling and apicoectomy of the tooth to be transposed.
- Intermediate storage in patient serum
- Removal of the tooth not worthy of preservation or creation of a sufficiently large receptacle for the tooth to be transposed.
- Insertion of the tooth with subsequent splinting to the adjacent teeth for the healing phase.
Prognosis
The success of the operation depends on the extent to which the tooth or tooth germ can be placed in a vascularized soft tissue bed and whether the periodontium of the tooth to be transplanted remains largely uninjured during its previous surgical removal. Furthermore, the transplanted tooth must not be loaded during the healing phase. Postoperative infection may also contribute to a worsening prognosis.
