Autotransplante dentário de pré-molares para região de incisivos: uma série de casos

Abstract

Tooth loss is among the main oral health problems, being a condition that can lead to functional, aesthetic and social damage, with repercussions on the individual's quality of life. Several etiologies can lead to tooth loss, including caries, periodontal disease and dental trauma. The latter can generate several complications such as: replacement resorption, pulp necrosis, inflammatory resorption and root canal obliteration. The treatment options for this tooth loss are conventional fixed prostheses, adhesive fixed prostheses, removable partial dentures, implant prostheses, orthodontics and autotransplantation. The latter is indicated for aesthetic regions due to its osteogenic potential, especially in cases where there is extensive bone resorption, and in growing patients, with premolars (PM) being the main substitutes for upper central incisors (ICS). The objective of this study is to report a series of cases that used the autotransplantation technique in patients with a history of dental trauma, periapical lesion and bone loss, highlighting the benefits of this technique. Data were collected from a convenience sample, from a private clinic in Fortaleza-CE, of adult patients of both sexes, with pre- and postoperative imaging exams, with at least 2 years of follow-up. Five patients were included, who underwent extraction of one or both ICS and minimally traumatic PM extraction at the same surgical time, with semi-rigid fixation with composite resin and reanatomization to mimic the aesthetics of the ICS. A total of 7 autotransplants were performed, 5 PM transplanted had closed root apex, 2 had open apex. Endodontic treatment was performed within 60 days after surgery in 4 transplanted teeth; in the 2 teeth with open apex, the conduct was follow-up; one of the transplanted PM already had previous endodontic treatment. Currently, the patients are in control of the procedure with a follow-up time ranging from 30 to 192 months without signs of resorption, ankylosis or periapical lesion, however, in 2 PM transplanted there was incomplete root formation. The presence of periodontal ligament in transplanted teeth has osteogenic potential, with the possibility of restoring bone height and promoting maintenance of periodontal tissues. Thus, it provides good aesthetics for dental rehabilitation in this region. In addition, it has low cost and good longevity, presenting itself as a long-term solution for tooth loss, and can also be used in patients in the growth phase.