Alternatives to root canal treatment: Tooth autotransplantation

Abstract

Although endodontic treatment is successful in most instances, some severely compromised teeth cannot be maintained in the long term. In children and adolescents, dental trauma can sometimes result in such severe damage to the tooth and supporting structures that tooth loss becomes inevitable. Also, a realistic long-term assessment of the prognosis of root canal treatment is required to be made when this treatment is carried out in a young patient, especially when the treated tooth has incomplete root development and a compromised crown/root ratio. Root fractures are often the medium term outcome of such root canal treated teeth. It is imperative that clinicians involved in the care of children with such injuries and faced with these clinical dilemmas undertake an interdisciplinary planning approach, which would give the patient a sustainable, biological long-term functional and aesthetic outcome. Autotransplantation is one such approach that should be considered to replace young permanent teeth where the long-term prognosis of endodontic management is not considered favourable. This chapter covers the rationale, indications, step-by-step treatment approach, and interdisciplinary planning that is required for a successful outcome of autotransplantation.