Stabilization of autotransplanted teeth using thermoplastic retainers

Abstract

Objective: Different fixation techniques have been used for stabilization of autotransplanted teeth. Because rigid or extended fixation periods can cause complications such as ankylosis and disturbances of pulpal revascularization, our aim was to evaluate an alternative technique, a removable splint, for improving the success rate of autotransplanted molar teeth. Study Design: In 44 patients, (20 male and 24 female patients), 45 transplanted teeth were analyzed. These cases were followed for 31 to 47 months after operation. Transplanted teeth were evaluated after use of a thermoplastic retainer for 1 month, in terms of success rate and dissatisfaction with this apparatus. The primary stability, ankylosis, and root resorption were also analyzed. Results: To date, 1 transplant was extracted after 6 months due to unpreventable periapical root inflammation, and 2 transplants were extracted after one year due to external root resorption. Although 2 ankylosed transplants were still functional after an average follow-up period of three years, with no dissatisfaction by the patients, these cases were treated as failures because of the probable risk for external root resorption. The remaining 40 (88.8 % success rate) transplants remained asymptomatic and functioning for a mean follow-up period of 37 months. In the assessment of dissatisfaction with the thermoplastic retainer, 36 (81.8 %) patients had no or little dissatisfaction, 4 (9 %) patients had very appreciable or excessive dissatisfaction, and 4 (9 %) patients had moderate dissatisfaction. Conclusions: A thermoplastic retainer for use after autotransplantation of third molar teeth is a reasonable and useful method and a good alternative to conventional rigid or semi-rigid splints. This technique was especially useful in autotransplanted teeth that had poor stability, i.e., in cases in which it is conventionally advised to use long-term rigid or semi-rigid splints.