A Long-term Study of 370 Autotransplanted Premolars. Part II. Tooth Survival and Pulp Healing Subsequent to Transplantation

The purpose of the present investigation was to determine the long-term prognosis of autotransplanted premolars with respect to tooth survival and pulpal healing. The material consisted of 195 patients aged 7 to 35 years, with a total of 370 autotransplanted premolars with observation period ranged from 1 to 13 years. Teeth transplanted with incomplete and complete root formation showed 95 per cent and 98 per cent long-term survival respectively: Pulp healing as evaluated by sensibility testing and radiographic signs of partial pulp canal obliteration was usually verified 6 months after transplantation. The frequency of pulpal healing (versus pulp necrosis), appeared to be closely related to stage of root development at time of transplantation. Teeth transplanted with incomplete and complete root formation showed 96 per cent and 15 per cent pulp healing respectively. Another and associated factor which could equally well predict pulpal healing was the diameter of the apical foramen of the graft. Finally, in teeth with completed root formation, the use of bursa with internal cooling and no extra-alveolar storage prior to transplantation seemed to increase the chance for pulpal healing. The present study indicates, that the size of the apical foramen and possibly the avoidance of bacterial contamination during the surgical procedure are explanatory factors for pulpal healing.