This document discusses autotransplantation of teeth for orthodontic treatment. Autotransplantation involves transplanting embedded, impacted or erupted teeth from one site to another in the same individual. Appropriate candidates for autotransplantation include teeth affected by trauma, impacted or ectopic teeth, developmentally absent teeth, and teeth with poor prognosis. Common teeth used are premolars, canines, incisors and third molars. The surgical procedure involves preparing the recipient site, atraumatically removing the donor tooth while preserving the root sheath, and placing the donor tooth into a loose fit in the recipient socket. Critical aspects for successful transplantation include splinting, endodontic treatment, root maturity, vertical height,

1. AUTOTRANSPLANTATION
OF TEETH IN ORTHODONTIC
TREATMENT.
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2. DEFINITION:
Auto transplantation may be
defined as the transplantation of
embedded, impacted or erupted
teeth, from one site to another in
the same individual in to extraction
sites or surgically prepared sockets.
(Natiella et al.,1970)www.indiandentalacademy.com

3. INDICATIONS:
1.Trauma.
2.Impacted or ectopic teeth.
3.Replacement of
developmentally absent teeth.
4.Teeth of poor prognosis.
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4. TOOTH SELECTION:
 Premolars
 Canines
 Incisors
 Third molars.
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5. SURGICAL PROCEDURE:
Receipient site should be prepared large
round bar internally cooled with saline..
Donor teeth should be removed
atraumatically – contact with root surface
should be avoided, to preserve Hertwig’s
root sheath.
Transplant donor tooth to a ‘loose fit ‘into
a recepients socket.
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6. Sedation, local anesthesia / general
anesthesia. Prophylactic antibiotic
cover for 7 days starting one hour proir
to surgery.
Place the tooth at a level in the
alvelolus corresponding to its original
transplant position (teeth with complete
root formation should be left out of
occlusion). www.indiandentalacademy.com

7. Vicryl/ silk suture ‘splint’ over occlusal
surface should be placed.
If stability of transplant is in doubt, e.g.
in cases if trauma , wire fixation may be
needed for 1-2 weeks.
Chlorhexidine mouthwashes for 7 days.
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8. CRITICAL ASPECTS:
1. Splinting.
2. Endodontic treatment.
3. Root maturity at transplantation.
4. Vertical occlusal height of the transplanted
teeth.
5. Pulp survival and the size of the apical
foramen.
6. Promotion of periodontal healing and
avoiding root resorption.
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9. Maxillary second
premolar transplanted
to the mandibular
region of the second
premolar
Clinical outlook after
3 months of
treatment(9 months
after transplantation)
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10. Radiograph after 1Yr.
Repair of the surface
resorption
Radiographic condition 3 months
after orthodontic rotation.
Note the surface root resorption.
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13. REFERENCE ARTICLE: J.C.O - 1999.
SEONG-HUN KIM(KOREA)
PREVENTION OF
GAGGING WITH
MODIFIED KROL’S
METHOD.
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14. The gag reflex is stimulated by
nerve endings in the soft
palate,pharynx, and pharngeal
area of the tongue.
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15. Other availble methods:
1.Pharmaco-therapeutics such as sedatives.
2.Antihistamines.
3.Antinauseants.
4.Topical anesthetics.
• DISADVANTAGE:
Side effects, makes patient more apprehensive.
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16. Krol’s Princile:
Krol’s Princile is –that gagging
is reduced in direct proportion
to the reduction of awareness
of the stimulus.
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18. If the gag reflex is deeply ingrained,
we may have to ask the patient to
raise both the foot and head during
tray insertion.
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