IADR Abstract Archives
Clinical, Radiological and Histological Healing Patterns After Tooth Autotransplantation
Objectives: This study aimed to evaluate the outcome of the cone-beam computed tomographic (CBCT)-guided tooth autotransplantation (TAT) compared to the conventional TAT protocol, and to assess the 3D and histological healing patterns after CBCT-guided TAT.
Methods: This study included 100 autotransplanted teeth in 88 patients. Each experimental group consisted of 50 transplants in 44 patients (31 males and 19 females). The mean age at the time of surgery was 10.7±1.1 years-old for the CBCT-guided group. This was 10.6±1.3 years-old for the conventional-group. The mean follow-up period was 4.5±3.1 years (range1.1-10.4 years). Two transplants were extracted after 12 and 24months were imaged using nano-focus computed tomography and processed histologically.
Results: Overall survival rate for the CBCT-guided TAT was 92% and success rate was 86% compared to 84% survival rate and 78% success rate for the conventional-group (P>0.005). The following measurements were extracted from the 3D analysis: root hard tissue volume (RV), root length (RL), apical foramen area (AFA), mean and maximum dentin wall thickness (Mean-DWT & Max-DWT). Overall, the mean percentage of tissue change was: RV gain by 65.8%±34.6, RL gain by 37.3%±31.5, AFA reduction by 91.1%±14.9, Mean-DWT increase by 107.9%±67.7, and Max-DWT increase by 26.5%±40.1. Principle component analysis (PCA) identified the Mean-DWT, RV and Max-DWT as the parameters best describing the tissue change after TAT. Cluster analysis applied to the variables chosen by the PCA classified the CBCT-group into 4 distinct clusters revealing different patterns of tissue healing after TAT. Histological analysis showed tubular reparative dentin formation and loss of normal pulp-dentin complex architecture.
Conclusions: The CBCT-guided approach increased the predictability of the treatment. The 3D and histological analysis provided insights into the patterns of healing.
Methods: This study included 100 autotransplanted teeth in 88 patients. Each experimental group consisted of 50 transplants in 44 patients (31 males and 19 females). The mean age at the time of surgery was 10.7±1.1 years-old for the CBCT-guided group. This was 10.6±1.3 years-old for the conventional-group. The mean follow-up period was 4.5±3.1 years (range1.1-10.4 years). Two transplants were extracted after 12 and 24months were imaged using nano-focus computed tomography and processed histologically.
Results: Overall survival rate for the CBCT-guided TAT was 92% and success rate was 86% compared to 84% survival rate and 78% success rate for the conventional-group (P>0.005). The following measurements were extracted from the 3D analysis: root hard tissue volume (RV), root length (RL), apical foramen area (AFA), mean and maximum dentin wall thickness (Mean-DWT & Max-DWT). Overall, the mean percentage of tissue change was: RV gain by 65.8%±34.6, RL gain by 37.3%±31.5, AFA reduction by 91.1%±14.9, Mean-DWT increase by 107.9%±67.7, and Max-DWT increase by 26.5%±40.1. Principle component analysis (PCA) identified the Mean-DWT, RV and Max-DWT as the parameters best describing the tissue change after TAT. Cluster analysis applied to the variables chosen by the PCA classified the CBCT-group into 4 distinct clusters revealing different patterns of tissue healing after TAT. Histological analysis showed tubular reparative dentin formation and loss of normal pulp-dentin complex architecture.
Conclusions: The CBCT-guided approach increased the predictability of the treatment. The 3D and histological analysis provided insights into the patterns of healing.