Thinking Outside the Box: Autotransplantation

Sometimes our job hands us tooth replacement cases in which traditional treatment therapy is either inadequate or impossible.

For instance, young patients who lose anterior teeth or have missing or malformed anterior teeth need treatment planning that caters to a growing individual since their teeth are still erupting and changing position. When these types of situations present themselves, you must think outside the box in order to achieve an esthetically pleasing result.

Generally, when you have a patient that has geminated central incisors or an ankylosed tooth, you'd extract the defective teeth and decide your treatment plan from a basic list of procedures. However, young patients that suffer from these defects require an uncommon – yet effective – treatment plan known as autotransplantation.

Although this procedure has only been around for roughly 50 years, it's widely used and highly successful in Scandinavian countries and is becoming more frequently used in the US.

Autotransplantation involves taking a tooth from one part of the mouth and transporting it to the defective area. Preferably, you would use a premolar in order for it to be successful procedure. The replacement tooth must have a strong root structure in order for process to be successful.

As the new tooth erupts, it brings the bone and gingiva down with it leaving any future natural tooth movement unaffected. The beauty of this treatment is using the patient's natural eruption to your advantage to help bring you and your patient to an attractive smile possibility or result.