See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/233394551

Developments in autotransplantation of teeth

Article in The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland November 2012
Impact Factor: 2.18 DOI: 10.1016/j.surge.2012.10.003 Source: PubMed

CITATIONS

READS

200

9 authors, including:
David Logan Cross

Ahmed M F El-Angbawi

University of Glasgow

Barts Health NHS Trust

15 PUBLICATIONS 225 CITATIONS

6 PUBLICATIONS 9 CITATIONS

SEE PROFILE

SEE PROFILE

John Whitters

Robert A. Mckerlie

University of Glasgow

University of Glasgow

45 PUBLICATIONS 543 CITATIONS

10 PUBLICATIONS 56 CITATIONS

SEE PROFILE

All in-text references underlined in blue are linked to publications on

ResearchGate, letting you access and read them immediately.

SEE PROFILE

Available from: David Logan Cross

Retrieved on: 21 June 2016

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

Available online at www.sciencedirect.com

The Surgeon, Journal of the Royal Colleges

of Surgeons of Edinburgh and Ireland
www.thesurgeon.net

Review

Developments in autotransplantation of teeth

a,

David Cross *, Ahmed El-Angbawi , Paul McLaughlin , Alex Keightley ,

a
a
a
b
a
Laetitia Brocklebank , John Whitters , Robert McKerlie , Laura Cross , Richard Welbury
a
b

The Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom
Glasgow Dental Hospital, Greater Glasgow and Clyde HB, NHS Scotland, United Kingdom

article info

abstract

Article history:

Transplantation of teeth has been done for hundreds of years. In the late 18th and early 19th century

Received 15 August 2012

Received in revised form 3
October 2012 Accepted 7
October 2012

transplants of teeth between individuals were relatively common at specialist dental practices in London.

Available online 8 November 2012

surgery. Recent developments in cone beam CT and rapid 3D prototyping have enabled the fabrication of

Surprisingly tooth allotransplants have been found to last 6 years on average. In Scandinavia during the 1950
and 1960s autotransplantation of teeth began to be carried out under increasingly controlled conditions. These
have proved to be very successful in long term studies with autotransplants surviving up to 45 years postaccurate surgical templates which can be used to prepare the recipient site immediately prior to

Keywords:

transplantation. This has resulted in a drastically reduced extra-oral time for the transplant teeth which can be

Autotransplants

expected to improve success rates further. Autotransplants provide significant advantages compared to single

Tooth

tooth implants and should be considered the treatment of choice in the growing child.

Orthodontics
2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of
Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Introduction
Transplanting teeth between individuals has been carried out for hundreds
and perhaps thousands of years but it was in the 18th century that the
practice became established. Famously, John Hunter conducted
experiments in transplantation and reported an incidence of a successful
1

tooth allotransplant in London gentleman in 1772. By this time tooth

transplants were relatively common in the city and a watercolour by
Thomas Rawlandson in 1787 shows A fashionable dentist engaged in
tooth transplantation (Fig. 1). The detail shown in this scene suggests that
it was produced from first-hand accounts of the practice. It illustrates that
these

practitioners in a pre-endodontic era, had learnt that for a successful

transplant, two things were vitally important. Firstly, immature teeth
worked best as donor teeth as the vascular supply would have a greater
chance of re-establishing in a tooth with a wide open apex, and secondly,
that immediate placement increased the chances of success by preserving
the vitality of the delicate periodontal ligament cells. However as in other
areas of surgery allotransplants have obvious disadvantages and
allotransplant teeth have been found to last only 6 years.

Autotransplantation of teeth was first described in the 1950s when

immature third molars were used to replace decayed first molars.
However, in the late 1950s papers

* Corresponding author. Orthodontic Department, Glasgow Dental Hospital, 378 Sauchiehall Street, Glasgow G2 3JZ, United Kingdom. Tel.: 44 (0)141 211 9873
E-mail addresses: David.Cross@glasgow.ac.uk, jimbomcd@blueyonder.co.uk (D. Cross).
1479-666X/$ e see front matter 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.
Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.surge.2012.10.003

50

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

Fig. 1 e Transplanting of teeth, by Thomas Rowlandson, 1787. By kind permission of The Hunterian Museum, The Royal College of Surgeons of
England.

recording autotransplantation of immature premolars began to appear.

4e6

Slagsvold and Bjercke published the first case series involving the
autotransplantation of immature premolars to the anterior maxilla. They
reported on 34 premolars transplanted between May 1959 and January
1970, with the teeth being followed up for an average duration of 6.2
years (range 3.3 yearse13.8 years). In 1985 Kristerson reported 93%
survival rate after following up 52 autotransplanted immature teeth for
8

almost the same average duration (6.3 years). Other authors have
published success and survival rates for autotransplantation (Table 1). In
1985, Schwartz et al. reported on 291 autotransplanted teeth, 121 of which
were premolars, placed between 1955 and 1980. For all tooth types they
found a 10-year survival rate of 56.6%, however the 10-year survival rate
9

for autotransplanted premolars was signif-icantly better, at over 75%. A

few years later Andreasen et al. conducted a study using a larger sample
size of

autotransplanted teeth. The authors followed 370 auto-transplanted

premolars for between 1 and 13 years using a standardised atraumatic
surgical technique, and demon-strated survival rates of 95% and 98% for
10

immature and mature transplanted teeth respectively. It was necessary

for the mature teeth to be root canal treated shortly after surgery to prevent
12

subsequent loss due to external root resorption. Kugelberg et al.

followed 23 immature and 22 mature teeth in 40 patients for up to 4 years,
and reported success rates of 96% and 82% respectively. Kristerson and
11

Lagerstrom fol-lowed up 50 consecutively autotransplanted teeth for an

average of 7 years, and reported a success rate of 82%. Czochrowska et
13

al. published the long term success of 30 autotransplanted teeth which

had been followed for a period of between 17 and 41 years (mean follow
up 26.4 years), and recorded success and survival rates of between 79%
and 90%. One of the major advantages in this study is that success and

Table 1 e Reported success and survival rates for autotransplanted immature teeth.
Success rate
Survival rate
7

Slagsvold and Bjercke, 1974

8

Kristerson, 1985
9
Schwartz et al., 1985
10
Andreasen et al., 1990
11
Kristerson and Lagerstrom, 1991
12
Kugelberg et al., 1994
13
Czochrowska et al., 2002
14
Jonsson and Sigurdsson, 2004
15
Tanaka et al., 2008
16
Kvint et al., 2010
17
Mensink and Van Merkesteyn, 2010
18
Vilhjalmsson et al., 2011

e
e
82%
96%
79%
92%
100%
81%

100%

6.2

93%
>56.6%
95%
e
e
90%

6.3
10
1e13
7.5
4
Up to 41
Up to 22
Up to 14
4.8
1e2
4.5

100%
100%

Follow up (Years)

Sample size (Teeth)

34
52
291
370
50
23
30
32
19
269
63
17

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

survival are clearly defined. Survival rate is defined as the percentage of

transplanted teeth still present at the time of examination relative to the
total number of teeth that were transplanted and success rate as the
percentage of trans-planted teeth that fulfil defined success criteria based
on previous work. These criteria for a transplant to be recorded a success
are; the absence of progressive root resorption, normal hard and soft
periodontal tissues adjacent to the transplant and a crown-root ratio of less
than one.

13

In line with the extended follow up duration, Jonsson and

Sigurdsson

14

51

19

scenarios ; 1. Loss of an anterior maxillary tooth or teeth due to trauma

or pathology, in which case lower second premolars are the tooth of
choice to be transplanted. 2. Hypodontia of one or two teeth in one arch in
the presence of crowding in the other arch, for example maxillary second
premolars may be substituted for absent lower second premolars. 3. Autotransplantation of ectopically positioned teeth to their correct position in
the same arch, for example ectopic canines can be moved by
autotransplantation if conventional surgical expo-sure and orthodontic
alignment is not appropriate. 4. First molars with poor prognosis can be
replaced with developing third molars.

recorded a 92% success rate after a follow up range of

16

2.5e26 years. Kvint et al. with a relatively large sample size reported
81% success rate after a mean duration of 4.8 years follow up. Moreover,
several recent case series report 100% success rate for immature
15e18

autotransplanted teeth after more than 4 years of follow up period.

Although encouraging, the sample sizes of some of these later studies are
relatively small (less than 20 teeth).
The majority of studies that evaluated autotransplantation treatment
outcome focused on the biological perspective of treatment. Czochrowska
13

et al. uniquely assessed patients and professionals perception to the

aesthetic outcome of autotransplanted premolar teeth in the maxillary
anterior region. The authors found that more than 80% of the patients and
dental professionals rated their aesthetic treatment outcome as satisfactory
or acceptable.
The survival rates for autotransplantation compare favourably with
those reported for single tooth osseo-integrated implants, resin bonded
bridges and fixed partial dentures (Table 2). However autotransplanted
teeth offer several advantages compared to osseo-integrated implants.
Autotransplants maintain a viable periodontal ligament, therefore they
continue to erupt along with the adjacent dentition during growth, making
19

them suitable for use in the growing child. A successful autotransplant

with a normally functioning periodontium will have proprioception and
provide thermal feedback like the adjacent teeth. These teeth can be
moved orthodontically using fixed orthodontic appli-ances. Finally they
will preserve alveolar bone volume and in the event of failure,
autotransplants do not exclude the option of an osseo-integrated implant
when growth is complete.

The replacement of missing anterior teeth can present a complex

problem. Missing or absent teeth results in a defi-ciency of alveolar bone
volume as a result of resorption which is compounded over time. This is a
particular concern in a child with a developing dentition and growing face
and jaws. Chil-dren can lose anterior teeth either due to congenital
hypodontia or dental trauma. The peak incidence for traumatic dental
injuries to the anterior maxillary region occurs between 8 and 12 years of
20

age. This is shortly before the establishment of the permanent dentition

and the pubertal growth spurt, both of which complicate the clinical
management of any resulting tooth loss. The treatment options available to
manage a missing anterior tooth in a growing child include; no treatment
and accept resulting malocclusion, space closure using orthodontic
appliances, space maintenance or space opening with ortho-dontic
appliances and fixed or removable prosthodontics to restore, and
autotransplantation. The best treatment option is often decided on a case
by case basis at a multidisciplinary orthodontic and restorative clinic. The
anterior dentition will be asymmetric if it is decided to accept the
malocclusion or close the space orthodontically (Fig. 2). The current gold
standard of treatment for such patients would be the provision of either a
removable or fixed prosthesis until facial growth is thought to be
completed with the provision of an osseo-integrated implant in early
adulthood. Osseo-integrated implants are contra-indicated in growing
children because they do not grow down with the developing dentition
and behave like an ankylosed tooth becoming increasingly infra-occluded.
Auto-transplantation may provide a better treatment alternative that does
not compromise the remaining dentition in the long term while preserving
21,22

alveolar bone volume.

A clinical protocol on the use of implants in
growing children suggests that when a single unit is missing, implants
should be withheld until dentoalveolar growth and development is
completed.

33

Indications
Autotransplantation can be considered in patients with no relevant
medical history in any of the following four clinical

Table 2 e Alternative treatment options for absent

Reported survival rates for resin bonded

anterior teeth.

bridge, fixed partial denture and single tooth implants.

Studies
Survival
rate
Single tooth implants

Systematic review

Follow up

94.5%

5 years

89.1%

10 years

87.5%

5 years

21

Fixed partial dentures

Resin bonded bridge

Jung et al.
Systematic review
22
Tan et al.
Systematic review
23
Pjetursson et al.

Fig. 2 e Anterior appearance of a patient with absent tooth

due to trauma.

52

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

Autotransplantation can be only justified if there is a donor tooth with

normal morphology that matches the recipient site available without
complicating the occlusion. The stage of root development of the donor

pre-surgical orthodontic treatment has created enough space to allow the

transplantation to take place.

26

11

tooth is of significant impact on the success of the autotransplantion.

Ideally the donor tooth should have half to three-quarters of the root
formed with undeveloped root apex. This will ensure the best chance of
revascularisation following surgery. However, auto-transplantation of
teeth with complete root formation can still be successful as long as root
canal treatment is completed either before or within 4 weeks of the
procedure to prevent significant root resorption.

The procedure of autotransplantation is technique sensi-tive and

requires a team approach that involves several dental specialities
including orthodontist, oral surgeon, paediatric dentist, dental radiologist
and technical support.
The ideal case for autotransplantation to replace a missing anterior
tooth is a child patient where premolar extractions are indicated for
orthodontic treatment of crowding and would otherwise be discarded. The
decision to proceed with autotransplantation should be reached before the
roots of the donor tooth are fully formed. Appropriate teeth to
autotransplant into the anterior maxilla are maxil-lary second premolars,
or mandibular first or second premolars, as their root morphology is not
significantly different from the teeth to be replaced. Autotransplantation of
maxillary first premolars is problematical due to root morphology with the
presence of two spindly roots. Modi-fying the crown of the graft tooth to
mimic the missing anterior tooth is a relatively straight forward procedure
with modern adhesive restorative techniques.

Successful autotransplantation is extremely reliant on operator skill in

carrying out the surgical procedure which is effectively a planned avulsion
and replantation, in an atrau-matic a method as possible. Kristerson and
11

Lagerstrom re-ported that all the teeth that went on the fail in their
study had reports of difficulties in the surgical removal from the donor
10

sites in the patient records. In the study by Andreasen et al., it was found
that several factors were significantly related to future development of
pulpal necrosis in the transplanted tooth, including length of extra-

Surgical technique
The classical autotransplantation technique involves the extraction of the
donor tooth and preparation of the recipient site, using the donor tooth as a
template. This can lead to extended extra-oral times and increase rate of
failure as the sensitive pulpal cells and periodontal ligament cells of the
donor tooth are devoid of a nutrient supply. The use of a surgical template
has been proposed to assist socket prep-aration to minimise the extraalveolar period of the donor tooth. This template can be used to re-model
the socket of the recipient site prior to extraction and autotransplantation.
It has been shown that if the donor tooth is stored extra-orally whilst the
socket is further modified significantly increases the probability of future
10

pulp necrosis. The use of surgical templates fabricated to average tooth

dimensions to facilitate autotransplantation has been reported
27

12

previously. Kugel-berg et al. reported the use of a selection of

previously extracted and sterilised teeth as surgical templates. These
previously extracted teeth would be sized against the pre-operative
radiograph of the graft tooth, and then the closest match would be used to
12

prepare the donor socket. Other surgical templates have been proposed
and include casting models of the extracted teeth in cobalt chrome to aid
effective sterilisation (Fig. 3) and the use of a series of preformed
templates of brass or copper (Fig. 4).

28

However, by creating a surgical template that is identical to the donor

tooth, the recipient site can be closely contoured to fit and thereby allow
the immediate placement of the trans-plant into the prepared socket. An
accurately contoured recipient site ensures that there will be an optimal
blood supply to promote revascularization if it has an immature apex,
whilst the reduced handling of the donor tooth reduces the possibility of
damage to the delicate periodontal ligament cells or Hertwigs root
sheath.

10

10

alveolar period. Here it was found that of graft teeth stored extraalveolar for <1 min, 7 out of 102 (7%), developed pulp necrosis, whilst
teeth stored for >1 min, 51 out of 258 (20%), would go on to develop pulp
necrosis.

Pre-surgical orthodontics
Pre-surgical orthodontics will involve planning treatment of the
malocclusion and the preparation of adequate space in the recipient site
before the surgical procedure. This may involve having fixed appliances
for few months before auto-transplantation to redistribute spaces and
upright root angu-lations to allow safe surgical positioning of the donor
tooth. Alternatively an upper removable appliance can be used to reduce
the overbite and help relieve occlusal trauma to the transplant in the
24

immediate post-surgical period.

Occa-sionally the tooth to be
transplanted will need to be extracted before there is adequate space
available at the donor site. These teeth can be stored indefinitely in liquid
nitrogen until

Cone Beam Computed Tomography (CBCT) can allow accurate three

dimensional imaging and pre-surgical

Cobalt chrome templates made from

average measurements.
Fig. 3 e

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

53

Fig. 5 e Cone beam CT scan of maxilla.

Fig. 4 e Copper templates used to prepare donor site. By kind

permission of Peter Day.

Harzer et al. have advocated the use of CBCT for post-operative

assessment of the transplant site and the donor tooth. Using the data, the
surgeon can assess the proposed transplant site for bone height and width,
proximity to surrounding struc-tures e.g. the inferior dental canal and
maxillary sinus and judge the best position of the donor tooth posttransplant.
Rapid three dimensional prototyping can use the data provided by the
CBCT to produce an accurate surgical template. Rapid three dimensional
prototyping is an engi-neering development which aims to create an
accurate physical three dimensional model quickly from computerised
29

data. Computer aided prototyping uses machines capable of adding

cumulative layer of material, generally either starch or resin, to produce
3D objects. Lee et al., reported the using measurements from conventional
30

spiral CT to produce surgical templates for autotransplantation of teeth.

They produced surgical templates in two ways, one from measurements
taken from the CT image, and the template produced first in wax then cast
in resin, and the other using a computer aided rapid 3D prototyping with a
3D printer to produce a surgical model in resin. These templates were
used in adult patients to facilitate autotransplantation of third molar teeth
to first molar sites.

31

monitoring of the autotransplanted tooth. Here CBCT allowed a full

evaluation of the periodontal ligament space and assessment of the root
surface for development of any resorptive defects.

Post-surgical treatment
Post-surgical orthodontics is required to treat any underlying malocclusion
and achieve the final positioning of the auto-transplant before definitive
restoration. In the first few months post-surgery it is an advantage to
ensure that the transplanted tooth is kept free from occlusal trauma.

Restoration
The transplanted tooth requires modification to improve its appearance as
it is unlikely that the transplanted tooth is of

This technique has been further refined by using CBCT to reduce

patient exposure to radiation, and by transplanting an immature premolar
25

in a growing child. In this case, a 2 unit space in the anterior maxilla

was treated in a 9 year old patient by autotransplanting a lower second
premolar and using fixed orthodontic appliances to detail the occlusion.
Data from a CBCT scan was exported in DICOM format (Fig. 5). This
data was manipulated with the appropriate software package to isolate the
donor tooth, and then sent to a 3D printer. This produced a 3D resin model
that was then cast into cobalt chrome to aid sterilisation and handling (Fig.
6).
The surgical procedure involved the preparation of the recipient site
using the preformed surgical template. The donor tooth was carefully
extracted, with the follicle present around the neck of the tooth, and then
immediately placed into the prepared socket. Finally it was sutured into
place. The extra-oral time from extraction of the donor tooth to transplantation is less than one minute.

Fig. 6 e Stages of template fabrication; 3D resin prototype with 1.5 mm

wax addition to root apex to compensate for root development, wax
model, cobalt chrome surgical template.

54

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

minimise the space between the donor tooth and the prepared bone ensure
the establishment of a good blood supply to the delicate cells of Hertwigs
root sheath and periodontal liga-ment cells. The use of these prototyped
surgical templates in combination with the improved pre-surgical planning
CBCT should improve the predictability of outcome for
autotransplantation.
Autotransplantation to restore absent or missing teeth in the upper
anterior region should be the treatment of choice in a growing patient with
underlying crowding where extraction and discarding of teeth are
considered as part of their ortho-dontic treatment.

references
Fig. 7 e Clinical appearances after successful autotransplant of
lower premolar tooth to upper right anterior region.

the same morphology as the tooth that was lost. The most common
procedure involves transplanting a premolar to the upper incisor region. A
temporary improvement in shape can be achieved by the use of composite
2e3 months after trans-plantation during the early stages of orthodontic
treatment (Fig. 7). The definitive restoration will be after orthodontic
treatment is complete and can either use composite or partial porcelain
veneer to match the shape and shade of the natural tooth.

13

Future developments
Future considerations in tooth transplants may include the use of
bioengineered teeth developed in vitro using stem cells from the patient to
32

avoid rejection problems. The applica-tion of autotransplants is limited

at present due to the scarcity of donor teeth. In theory xenotransplants
could fill this gap in availability of donor teeth especially in patients
with moderate to severe hypodontia, but the use of xenotrans-plants raises
important ethical issues. If xenotransplanted or bioengineered teeth are
ever advocated 3D prototyping will be useful in analysing the donor site
and creating surgical templates to improve the chance of success of the
trans-plantation procedure.

Conclusions
Developments in autotransplantation, in particular the use of CBCT, can
improve planning and help to create an accurate surgical template by
using rapid 3D prototyping. This approach has the potential to enhance the
success of auto-transplantation of teeth by making the technique less
operator sensitive and to dramatically reduce extra-oral time for the
transplant. The surgical template should give the surgeon greater
confidence to prepare the recipient site correctly con-toured to the
morphology of the donor tooth. This will

1. Hunter J. A practical treatise on the diseases of the teeth; intended as a

supplement to the natural history of those parts 1778. p. 111.
2. Schwartz O, Fredricksen K, Klausen B. Allotransplantation of human
teeth. A retrospective study of 73 transplants over
a period of 28 years. Int J Oral Maxillofac Surg 1987;16:285e301.
3. Apfel H. Autoplasty of enucleated prefunctional third molars. J Oral Surg
(Chic) 1950 Oct;8(4):289e96.
4. Serling L. Surgical repositioning of an impacted mandibular bicuspid. J
Am Dent Assoc 1959 Sep;59:553e4.
5. Dixon DA. Autogenous transplantation of tooth germs into the upper
incisor region. Br Dent J 1971 Sep 21;131(6):260e5.
6. Hansen J, Fibaek B. Clinical experience of auto- and allotransplantation
of teeth. Int Dent J 1972 Jun;22(2):270e85.
7. Slagsvold O, Bjercke B. Autotransplantation of premolars with partly
formed roots. A radiographic study of root growth. Am J Orthod
1974;66(4):355e66.
8. Kristerson L. Autotransplantation of human premolars:
a clinical and radiographic study of 100 teeth. Int J Oral Surg 1985
Apr;14(2):200e13.
9. Schwartz O, Bergmann P, Klausen B. Autotransplantation of human teeth.
A life-table analysis of prognostic factors. Int J Oral Surg 1985
Jun;14(3):245e58.
10. Andreasen JO, Paulsen HU, Yu Z, Bayer T, Schwartz O. A long-term
study of 370 autotransplanted premolars. Part II. Tooth survival and pulp
healing subsequent to transplantation. Eur J Orthod 1990
Feb;12(1):14e24.
11. Kristerson L, Lagerstrom L. Autotransplantation of teeth in cases with
agenesis or traumatic loss of maxillary incisors. Eur J Orthod 1991
Dec;13(6):486e92.
12. Kugelberg R, Tegsjo U, Malmgren O. Autotransplantation of 45 teeth to
the upper incisor region in adolescents. Swed Dent J 1994;18(5):165e72.
13. Czochrowska EM, Stenvik A, Bjercke B, Zachrisson BU. Outcome of
tooth transplantation: survival and success rates 17e41 years
posttreatment. Am J Orthod Dentofacial Orthop
2002 Feb;121(2):110e9. 193.
14. Jonsson T, Sigurdsson TJ. Autotransplantation of premolars to premolar
sites. A long-term follow-up study of 40 consecutive patients. Am J
Orthod Dentofacial Orthop
2004;125(6):668e75.
15. Tanaka T, Deguchi T, Kageyama T, Kanomi R, Inoue M, Foong KWC.
Autotransplantation of 28 premolar donor teeth in 24 orthodontic patients.
Angle Orthod 2008;78(1):12e9.
16. Kvint S, Lindsten R, Magnusson A, Nilsson P, Bjerklin K.
Autotransplantation of teeth in 215 patients a follow-up study. Angle
Orthod 2010;80(3):446e51.
17. Mensink G, Van Merkesteyn R. Autotransplantation of premolars.
Br Dent J 2010;208(3):109e11.

t h e s u r g e o n 1 1 ( 2 0 1 3 ) 4 9 e5 5

18. Vilhjalmsson VH, Knudsen GC, Grung B, Bardsen A. Dental autotransplantation to anterior maxillary sites. Dent Traumatol
2011;27(1):23e9.
19. Park JH, Tai K, Hayashi D. Tooth autotransplantation as a treatment
option: a review. J Clin Pediatr Dent 2010;35(2):129e35.

55

of cone beam CT and computer-aided prototyping: a case report. Dent

Traumatol 2010;26(2):195e9.
26. Temmerman L, De Pauw GA, Beele H, Dermaut LR. Tooth
transplantation and cryopreservation: state of the art. Am J Orthod
Dentofac Orthop 2006;129:691e5.
27. Meechan JG, Carter NE, Gillgrass TJ, Hobson RS, Jepson NJ, Nohl FS, et
al. Interdisciplinary management of hypodontia: oral surgery. Br Dent J
2003;194:423e7.
28. Day PF, Lewis BRK, Spencer RJ, Barber SK, Duggal M. The design and
development of surgical templates for premolar transplants in
adolescents. Int Endod J 2012 [Online].

20. Andreasen J. Textbook and color atlas of traumatic injuries to the teeth.
4th ed. Blackwell Publishing; 2007.
21. Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A
systematic review of the 5-year survival and complication rates of
implant-supported single crowns. Clin Oral Implants Res
2008;19(2):119e30.
22. Tan K, Pjetursson BE, Lang NP, Chan ESY. A systematic review of the
survival and complication rates of fixed partial dentures (FPDs) after an
observation period of at least 5 years III. Conventional FPDs. Clin Oral
Implants Res
2004;15(6):654e66.
23. Pjetursson BE, Tan WC, Tan K, Bragger U, Zwahlen M, Lang NP. A
systematic review of the survival and complication rates of resinbonded bridges after an observation period of at least 5 years. Clin Oral
Implants Res 2008;19(2):131e41.

29. Sachs E, Cima M, Cornie J. Three-dimensional printing: rapid tooling and

prototypes directly from a CAD model. CIRP Ann Manuf Technol
1990;39(1):201e4.
30. Lee SJ, Jung IY, Lee CY, Choi SY, Kum KY. Clinical application of
computer-aided rapid prototyping for tooth transplantation. Dent
Traumatol 2001 Jun;17(3):114e9.
31. Harzer W, Ruger D, Tausche E. Autotransplantation of first premolar to
replace a maxillary incisor e 3D-volume tomography for evaluation of
the periodontal space. Dent Traumatol 2009 Apr;25(2):233e7.

24. Amos M, Day P, Littlewood S. Autotransplantation of teeth: an overview.

Dent Update 2009 Mar;36(2):102e13.
25. Keightley AJ, Cross DL, McKerlie RA, Brocklebank L.
Autotransplantation of an immature premolar, with the aid

32. Sartaj R, Sharpe P. Biological tooth replacement. J Anat

2006;209:503e9.
33. Sharma A, Vargervik K. Using implants for the growing child.
J Calif Dent Assoc 2006;34:719e24.