Tooth transplantation - specialists and information

The consequences of missing teeth

The quality of your teeth depends largely on whether the teeth support each other and whether they have counterparts in the upper and lower jaw when chewing and biting.

If there is a gap between your teeth, this has negative consequences for the remaining teeth: they can no longer support each other through the gap. In technical jargon, this is referred to as tilting of the teeth.

This means that the counterpart of the missing tooth automatically lengthens in order to restore contact when biting down. In the long term, the jawbone that lies under the gap between the teeth recedes. It recedes because it lacks the chewing pressure and therefore the load.

Dentists therefore recommend closing a tooth gap as soon as possible. This can be done as follows:

• With an orthodontic gap closure (braces)
• With a prosthetic restoration(bridge or implant)
• With a tooth transplant

Tooth transplants make it possible to replace missing teeth biologically @ Alexandre / AdobeStock

The tooth transplant

Tooth gaps are often caused by trauma or dental disease. A tooth transplant is useful in the following cases:

• Early tooth loss due to tooth decay or bacterial root tip inflammation(periodontitis apicalis)
• Tooth loss due to trauma during growth (falls or accidents during sport, play or other activities involving the mouth and facial area)
• Localized juvenile periodontitis (= bacterial inflammation of the periodontium affecting less than 30 percent of the tooth surfaces, usually occurring in young adults under 30)
• Infection-related root resorption (= breakdown of the tooth structure in the root area)
• Permanent fusion of the tooth root with the jaw (often after dental trauma and in milk teeth whose successor has not been created)
• Breakthrough disorder in canines
• Unsuccessful exposure and attachment ("extraction") of displaced and/or impacted (not or only partially erupted) teeth
• Tooth gaps also occur when teeth are not genetically formed (= dental aplasia). In this case, the permanent molars or front teeth do not form after the primary dentition.

Types of tooth transplantation

Depending on where your dentist removes the tooth and where he transplants it, he distinguishes between the following types of transplantation:

• Autogenous tooth transplantation: In autogenous tooth transplantation, the tooth is transplanted to another location in a patient's mouth.
• Isogenic tooth transplantation: The patient receives a tooth from a genetically identical person, e.g. identical twins.
• Allogeneic tooth transplantation: The patient receives a tooth from a person who is not genetically identical.

Today, autogenous tooth transplantation is an integral part of dentistry. @ ViDi Studio / AdobeStock

Advantages of a tooth transplant

Oral and maxillofacial surgeons today only perform autogenous tooth transplants because they do not expect any immune reactions. Your immune system does not classify the body's own material as foreign and therefore does not reject it (unlike materials such as metals and alloys).

The risk of intolerance is therefore extremely low. In addition, unlike an implant, a transplanted tooth grows in the jaw like a natural tooth. This is particularly advantageous for younger patients, as their teeth are still growing.

Which teeth are suitable for a tooth transplant

For a successful tooth transplant, your dentist will use

• Wisdom teeth
• Premolars (small molars)
• Milk canine teeth

Tooth transplants in children and adolescents have the best chances of success, as the teeth are still growing (= teeth with immature roots). However, your dentist can also transplant adult teeth with a good chance of success.

Procedure for a tooth transplant

Before the tooth transplantation, your dental surgeon will check the condition of the tooth to be transplanted. He will also check the edentulous section of the jaw.

X-rays show whether the tooth is healthy and what stage of growth it is in. He also checks whether the intended graft bed (the area where the new tooth will be implanted) is suitable.

He will then discuss with you whether you would like to have the tooth transplant performed in one or two stages:

• In a one-stage transplant, your doctor prepares the graft bed, removes the tooth (graft) and transplants it to the desired location within a single session.
• In a two-stage transplant, your dentist first prepares the transplant bed in the first session. In the second session a few days later, he or she transplants the tooth graft.

Your dentist can transplant the healthy tooth during treatment. To do this, he prepares the space in the mouth where the new tooth will be placed. Sometimes he has to enlarge the space. If there is a diseased tooth in this place, he will extract it first. Your dentist then places the healthy tooth in the empty space and secures it with flexible braces. You will be under local anesthesia during the entire treatment.

If the newly inserted tooth is smaller than the one next to it, you will also receive a crown. If the new tooth has problems with the roots, your dentist will carry out root canal treatment.

Aftercare following a tooth transplant

After the operation you should

• Do not drink hot drinks
• Do not smoke
• No physical exertion
• Use ice packs or cold cloths to reduce swelling
• Take medication to reduce inflammation and pain
• Keep your mouth very clean and use rinses that kill germs.

In addition, you must not put excessive strain on the transplanted tooth during the healing period. After about 7 to 10 days, your dentist will remove the stitches and the splint.

Two months after the transplantation, he will check the healing process using a perio test. After around eight weeks, the pulp of a young tooth will have formed again and the tooth will have regained its sensitivity. This takes a little longer in adults.

After transplantation of root-immature teeth, your dental surgeon will also check the ingrowth of the transplanted tooth at least once a quarter in the first year after the procedure using x-rays, and every six months in the following year.

Start cooling immediately after the operation to prevent swelling. @ absolutimages / AdobeStock

Conclusion

Today, tooth transplants are a good and established alternative to implants and replace lost or missing teeth in a natural way.

Dentists are transplanting teeth with great success, especially in young people. As the jaw is still growing, the transplanted teeth grow well and then continue to develop like natural teeth.