Tooth autotransplantation with adjunctive application of enamel matrix derivatives using a digital workflow: A prospective case series

doi:10.1016/j.jdent.2024.105131

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AutoresIgnacio Pedrinaci, Javier Calatrava, Emilio Couso-Queiruga, Juan del Rosal Bethencourt, Ignacio Sanz-Sanchez, German O. Gallucci, Mariano Sanz

Por qué importa

Este estudio prospectivo evalúa la eficacia de un protocolo de autotransplante dental completamente digital para molares con ápice cerrado, complementado con derivados de la matriz del esmalte (EMD). Se investigó el rendimiento de este enfoque en trece dientes de pacientes adultos durante dos años, analizando tasas de supervivencia y éxito, parámetros clínicos, endodónticos y radiográficos, así como la satisfacción del paciente. Los resultados preliminares sugieren altas tasas de éxito y supervivencia, junto con una preservación significativa de la profundidad de sondaje y ganancia de nivel de inserción clínica, además de estabilidad en los niveles óseos alveolares y mínimos cambios en los márgenes gingivales. La experiencia del paciente reportada fue muy positiva. Esta investigación aporta evidencia sobre un método avanzado para la sustitución de dientes irrecuperables, validando también la evaluación digital de la conservación alveolar en el sitio receptor.

Abstract original

OBJECTIVES: Digital protocols and bioactive materials may reduce complications and improve tooth autotransplantation (ATT) success and survival rates. This prospective study assesses the performance of a fully digital autotransplantation protocol of close-apex molars with the adjunctive application of Enamel Matrix Derivatives (EMD). METHODS: Twelve adult patients with 13 hopeless molar teeth were replaced with autotransplantation of closed apex third molars. Outcomes, including success and survival rates, clinical, endodontic, radiographic, patient-reported outcome measures (PROMs), and digital image assessments, were conducted over a two-year follow-up period. RESULTS: Survival and success rates were 100% and 91.2%, respectively, with no progressive inflammatory or replacement root resorption (ankylosis) except for one tooth presenting radiographic furcation involvement. A significant probing depth reduction of 2.4 ± 2.58 mm and CAL gains of 2.8 ± 3.03 mm were observed in transplanted teeth compared to the hopeless receptor teeth. Radiographic bone levels remained stable throughout the study period (-0.37 ± 0.66 mm), and digital image assessments showed minimal alveolar ridge width changes (-0.32 to -0.7 mm) and gingival margin changes (-0.95 to -1.27 mm) from baseline to last visit. PROMs indicated very high patient satisfaction. CONCLUSION: The use of a digital ATT protocol with adjunctive use of EMD in closed-apex third molars demonstrated promising short-term high success and survival rates. Additionally, this type of therapy adequately preserves the dimensions of the alveolar ridge in the receptor site. CLINICAL SIGNIFICANCE: This is the first prospective clinical study examining the effect of a digital tooth autotransplantation protocol combined with the application of EMD. It demonstrates that this approach is an effective treatment for replacing hopeless teeth and also validates the digital assessment of ATT alveolar ridge preservation at the recipient site.

Leer texto completo ↗DOI · 10.1016/j.jdent.2024.105131

Autores Doctor&Cols

Cómo citar

Pedrinaci I, Calatrava J, Couso-Queiruga E, Bethencourt JDR, Sanz-Sanchez I, Gallucci GO, et al. Tooth autotransplantation with adjunctive application of enamel matrix derivatives using a digital workflow: A prospective case series. Journal of Dentistry. 2024. doi:10.1016/j.jdent.2024.105131