PMC8643253_01
The initial clinical presentation of #18 with gross caries extending to the subgingival margin.
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Tooth #18 was considered as a nonrestorable tooth based on the clinical and periapical radiograph (Figures 1 and 2).
Periapical radiograph at the initial appointment. Large periapical radiolucency was present on the second molar. The gross caries reached to the almost alveolar bone level on the radiograph. This was deemed as a nonrestorable tooth.
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Tooth #18 was considered as a nonrestorable tooth based on the clinical and periapical radiograph (Figures 1 and 2).
Panoramic radiograph showed that horizontal impaction of #17 was noted. The apical part of #17 was fully formed.
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Panoramic radiograph showed large periapical radiolucency on #18 and relatively a conical shape of the #17 root form (Figure 3).
Immediate after of minimal traumatic extractions of #17 and 18. #17 was kept in the saline until this was used.
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Following the extraction of #17 with the caution of saving periodontal regiment, the removed #17 was temporarily stored in a glass petri dish with 0.9% of saline solution (Figure 4).
Tooth #17 was transplanted into the #18 site. Interrupted sutures were rendered to proximate the gingival tissues.
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An occlusal adjustment was completed to remove any contacts to the opposing arch on the transplanted tooth (Figure 5).
One year follow-up from the surgical procedure. Slight apical radiolucency was noted in the transplanted tooth. Soft tissue healing was uneventful. Slight inadequate root canal filing material was noted on the distal root of the transplanted tooth.
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Slightly inadequate root canal filling material was noted on the distal root of the transplanted tooth (Figure 6).
Ten-year follow-up after the transplantation. The size of the apical radiolucency reduced from one year after the procedure.
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A periapical radiograph and clinical examinations showed reduced periapical radiolucency and periodontal stability ten years after the procedure (Figure 7).
Twenty-eight years after the transplantation. Probing depth was less than 3 mm and gingival health was confirmed. There is no alveolar bone loss that was noted around the transplanted tooth. A radiolucency was noted in the pulp chamber which reached to the furcation area. However, no clinical pathological changes were noted.
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At the 28-year follow-up in 2017, probing depth around the tooth showed within 3 mm without bleeding on probing and the interdental bone level was within 2 mm from cement enamel junction (Figure 8).
CBCT revealed the presence of buccal and lingual bone on both mesial (a) and distal (b) roots of the transplanted tooth.
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Cone beam computed tomography (CBCT) showed the absence of root resorption and the presence of buccal and lingual bone on the transplanted tooth (Figure 9).
Twenty-nine years after the procedure, this patient maintains good oral hygiene and gingival health.
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After 29 years of the procedure, in February 2018, the transplanted tooth was still functioning without any discomfort or symptoms (Figures 10 and 11).
Panoramic radiograph demonstrated the no sign of alveolar bone loss on the transplanted tooth. This patient has maintained all the teeth for almost 30 years from initial appointment.
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After 29 years of the procedure, in February 2018, the transplanted tooth was still functioning without any discomfort or symptoms (Figures 10 and 11).