Trapianti e reimpianti dentali: valide alternative all’implantologia nelle regioni molari di mandibola e maxilla

Tooth transplantation or intentional replantation could be considered as a viable therapeutic options for rehabilitating posteriorior area of young patients with a seriously damaged or lost permanent molar. If its conservative restoration would result complex and with an unfavorable long-term prognosis, due to patients young age implant or prosthetic solutions would require different remakings over lifetime, in addition to long time necessary for the final prothesis delivery. The autotransplantation technique allows us to replace immediately the compromised or lost molar with an undamaged tooth and to preserve the benefits derived from the conservation of the periodontal ligament vitality. In intentional tooth replantation molars with an unsuccessfull endodontic treatment can be saved with a complete functional restitutio ad integrum. For this study we selected 10 patients who presented seriously compromised molars and at the same time partially or completly impacted wisdom tooth. In a single operatory session compromised teeth have been extracted and immediately replaced with the homolateral or controlateral impacted wisdom tooth removed with an atraumatic technique. All the transplanted elements have been stabilized with an extra-coronal splint for 4 weeks and afterwards devitalized immediately before the splint removal. For the teeth treated with intentional replantation together with the atraumatic extraction an apicoectomy and a subsequent retrofilling of all the roots was performed. Replanted teeth have seldom required a post operative splint, because of the general substantial primary stability obtained. The transplanted or replanted teeth have been monitored for one year after the treatment from both a periodontal and an endodontic point of view. All the dental elements 12 months after the procedure didn’t show any alteration of the periodontal reference parameters. No periapical lesion appeared in the same time, while the pre-existing ones resulted healed. All the teeth are functionally active with normal occlusal contacts. Intentional replantation and tooth transplantation procedures proved to be effective alternatives to traditional implant and prosthetic procedures.