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Multiple traumatised upper incisors in children treated by autotransplantation and orthodontics — a 4-year follow-up

Chieh Shen Koo
Chieh Shen Koo
, 
Boon Hui Chan
Boon Hui Chan
 et 
Ruixiang Yee
Ruixiang Yee
   | 29 déc. 2023
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Publié en ligne: 29 déc. 2023
Pages: 160 - 173
Reçu: 01 sept. 2023
Accepté: 01 nov. 2023
DOI: https://doi.org/10.2478/aoj-2023-0033
© 2023 Chieh Shen Koo et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

(A–C) Pretreatment extra-oral photographs. (D—H) Pretreatment intra-oral photographs.
(A–C) Pretreatment extra-oral photographs. (D—H) Pretreatment intra-oral photographs.

Figure 2.

(A) Pretreatment dental panoramic radiograph. (B) Periapical radiograph showing resorption on the apical surfaces of #12 and #21. (C) Lateral cephalogram. (D) CBCT section showing developing tooth #45 with ¾ root length.
(A) Pretreatment dental panoramic radiograph. (B) Periapical radiograph showing resorption on the apical surfaces of #12 and #21. (C) Lateral cephalogram. (D) CBCT section showing developing tooth #45 with ¾ root length.

Figure 3.

(A) Periapical radiograph taken 2 weeks post-autotransplantation. (B)Transplanted tooth secured with a flexible wire splint. (C) Composite build-up of the transplanted tooth 1-month post-autotransplantation.
(A) Periapical radiograph taken 2 weeks post-autotransplantation. (B)Transplanted tooth secured with a flexible wire splint. (C) Composite build-up of the transplanted tooth 1-month post-autotransplantation.

Figure 4.

(A–E) Midtreatment intra-oral photographs.
(A–E) Midtreatment intra-oral photographs.

Figure 5.

(A-C) Posttreatment extra-oral photographs. (D-G) Posttreatment intra-oral photographs.
(A-C) Posttreatment extra-oral photographs. (D-G) Posttreatment intra-oral photographs.

Figure 6.

(A) Posttreatment panoramic radiograph. (B) Periapical radiograph of transplanted tooth showing good root length and pulp canal obliteration. (C) Lateral cephalogram. (D) 4-year follow-up of the transplanted tooth #45 showed blunting of the root apex and a localized concavity on the mesial aspect of the root. The tooth should be reviewed in the longer term to assess for any developing signs of root resorption.
(A) Posttreatment panoramic radiograph. (B) Periapical radiograph of transplanted tooth showing good root length and pulp canal obliteration. (C) Lateral cephalogram. (D) 4-year follow-up of the transplanted tooth #45 showed blunting of the root apex and a localized concavity on the mesial aspect of the root. The tooth should be reviewed in the longer term to assess for any developing signs of root resorption.

Figure 7.

(A-C) Pretreatment extra-oral photographs. (D-H) Pretreatment intra-oral photographs.
(A-C) Pretreatment extra-oral photographs. (D-H) Pretreatment intra-oral photographs.

Figure 8.

(A) Pretreatment panoramic radiograph. (B) Periapical radiograph showing decoronated #11 and crown attached; Resorption on the apical surfaces of #12 and #21. (C) Lateral cephalogram. (D) CBCT section showing developing tooth #35 with ⅔ root length and (E) Developing tooth #45 with ¾ root length.
(A) Pretreatment panoramic radiograph. (B) Periapical radiograph showing decoronated #11 and crown attached; Resorption on the apical surfaces of #12 and #21. (C) Lateral cephalogram. (D) CBCT section showing developing tooth #35 with ⅔ root length and (E) Developing tooth #45 with ¾ root length.

Figure 9.

(A) Periapical radiograph taken 1 week post-autotransplantation; teeth #35 and #45 secured with a flexible wire splint. (B) Lower second premolars transplanted into the anterior maxilla region. (C) Composite build-up 2 months post-autrotransplantation.
(A) Periapical radiograph taken 1 week post-autotransplantation; teeth #35 and #45 secured with a flexible wire splint. (B) Lower second premolars transplanted into the anterior maxilla region. (C) Composite build-up 2 months post-autrotransplantation.

Figure 10.

(A-E) Midtreatment intra-oral photographs.
(A-E) Midtreatment intra-oral photographs.

Figure 11.

(A-C) Posttreatment extra-oral photographs. (D-H) Posttreatment intra-oral photographs.
(A-C) Posttreatment extra-oral photographs. (D-H) Posttreatment intra-oral photographs.

Figure 12.

(A) Posttreatment panoramic radiograph. (B) Periapical radiograph of autotransplanted teeth showing good root length and pulp canal obliteration. (C) Lateral cephalogram. (D) 4-year follow-up of the transplanted teeth showing adequate root lengths and optimal intra-crestal bone levels. Pulp canal obliteration was seen in both transplanted teeth.
(A) Posttreatment panoramic radiograph. (B) Periapical radiograph of autotransplanted teeth showing good root length and pulp canal obliteration. (C) Lateral cephalogram. (D) 4-year follow-up of the transplanted teeth showing adequate root lengths and optimal intra-crestal bone levels. Pulp canal obliteration was seen in both transplanted teeth.

Cephalometric measurements (Case 1)

Pretreatment Posttreatment
SNA (°) 82.5 81.5
SNB (°) 78.0 78.0
ANB (°) 4.5 3.5
WITS appraisal (mm) -2.0 -2.5
FMA (°) 22.5 23.5
Lower anterior face height (%) 52.7 54.3
U1 to FH (°) 135.0 112.0
IMPA (°) 97.0 99.0
Interincisal angle (°) 106.0 130.0
Upper lip to E-line (mm) 6.0 2.0
Lower lip to E-line (mm) 3.0 0.0

Cephalometric measurements (Case 2)

Pretreatment Posttreatment
SNA (°) 84.5 84.0
SNB (°) 84.0 83.0
ANB (°) 0.5 1.0
WITS appraisal (mm) -2.5 -2.0
FMA (°) 26.0 26.0
Lower anterior face height (%) 57.6 55.2
U1 to FH (°) 124.0 119.0
IMPA (°) 99.5 94.0
Interincisal angle (°) 117.0 123.0
Upper lip to E-line (mm) -1.0 -1.0
Lower lip to E-line (mm) 3.0 1.0
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