Work

Tooth autotransplantation following extraction of periodontally hopeless teeth in a periodontitis patient

Year: 2026

Type: article

Abstract: BACKGROUND: The aim of the study is to report clinical outcomes of autogenous tooth transplantation (ATT) of fully developed third molars following the extraction of periodontally hopeless teeth as a part of the treatment of a stage III, grade C, molar-incisor pattern (MIP) periodontitis case. METHODS: A 24-year-old female with stage III, grade C, MIP periodontitis was treated at Operative Unity of Dentistry, Azienda Unità Sanitaria Locale, Ferrara. Despite steps I and II of periodontal therapy, deep pockets and severe mobility remained at maxillary and mandibular right first molars, which were scheduled for extraction due to a hopeless periodontal prognosis. At the time of extraction, the maxillary and mandibular right third molars (18 and 48) were transplanted in the severely compromised sockets of 16 and 46, respectively. The patient received supportive periodontal care with a 4-month frequency. RESULTS: At 24 months, both transplanted teeth efficiently contributed to the masticatory function. The monitoring of periodontal parameters showed periodontal depth (PD) ≤ 4 mm, and the bone level amounted to more than 50% of the root length at both sites. A clinical attachment loss of 5 mm was recorded only at the buccal site of the donor tooth 48. No signs of root resorption or endodontic lesions were present. Overall, the number of pockets with PD ≥ 4 decreased from 32 to 4, and the full mouth bleeding score from 76% to 32%. CONCLUSIONS: ATT can be a viable option to replace periodontally hopeless teeth in patients with severe periodontitis, contributing to the overall improvement of periodontal conditions. KEY POINTS: Autogenous tooth transplantation may represent a viable alternative for the rehabilitation of sites severely compromised by periodontitis in molar-incisor pattern patients. The periodontal ligament of the donor tooth can induce bone formation and regenerate periodontal tissues. PLAIN LANGUAGE SUMMARY: This case report describes a 24-year-old woman affected by a severe and rapidly progressing form of periodontitis mainly involving the molars. Despite conventional periodontal therapy, two molars were considered hopeless and required extraction. As part of the rehabilitation plan, the patient's wisdom teeth were used as donor teeth and transplanted into the extraction sites through autogenous tooth transplantation (ATT). After 2 years of follow-up and regular supportive periodontal care, both transplanted teeth remained stable and functional, showing no signs of complications. Moreover, the patient's overall periodontal condition showed marked improvement. This case highlights that, in carefully selected patients, ATT can represent a viable alternative to conventional tooth replacement methods for managing advanced periodontitis.

Source: Clinical Advances in Periodontics

DOI: 10.1002/cap.70060

Authors: Alessandro Rizzi, Giorgia Astolfi, Roberto Farina, Leonardo Trombelli

Institutions: University of Ferrara, Azienda Unità Sanitaria Locale di Ferrara

Language: English

Topic: Dental Trauma and Treatments

Subfield: Emergency Medical Services

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,300