Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis

Auto-transplantation is a procedure that replaces traumatized or congenitally missing teeth. While most auto-transplanted teeth are successfully integrated into recipient sites, the donor tooth may develop apical periodontitis, causing early failure. In the present case report, the periodontic resid...

Full description

Saved in:
Bibliographic Details
Main Authors: Christopher M. Naglieri, Ellie Bash, Glen A. Karunanayake, Carlos H. R. Camargo, Takashi Komabayashi
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Dentistry
Online Access:http://dx.doi.org/10.1155/2023/9389760
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832546727330054144
author Christopher M. Naglieri
Ellie Bash
Glen A. Karunanayake
Carlos H. R. Camargo
Takashi Komabayashi
author_facet Christopher M. Naglieri
Ellie Bash
Glen A. Karunanayake
Carlos H. R. Camargo
Takashi Komabayashi
author_sort Christopher M. Naglieri
collection DOAJ
description Auto-transplantation is a procedure that replaces traumatized or congenitally missing teeth. While most auto-transplanted teeth are successfully integrated into recipient sites, the donor tooth may develop apical periodontitis, causing early failure. In the present case report, the periodontic resident performed the procedure on a 15-year-old male by selecting donor teeth #4 and #13 and transplanting them at recipient sites #29 and #20, respectively. After 6 weeks, the patient was referred to the endodontic resident for evaluation of tooth #20 due to symptom development. While one auto-transplanted tooth (donor tooth #4, recipient site #29) was successfully integrated, the other (donor tooth #13, recipient site #20) was unsuccessful: the patient was diagnosed with pulp necrosis and a chronic apical abscess. Because of the patient’s age, collaboration among periodontic, endodontic, and orthodontic residents/specialists informed the clinical decision to pursue non-surgical root canal treatment (NSRCT) rather than extraction. The canal was cleaned and shaped to a size #80 using copious irrigation of 2.5% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA) via the EndoVac Negative Pressure Irrigation system. The tooth was dried with paper points, and then calcium hydroxide was mixed with 2.5% NaOCl and placed with an amalgam carrier 2 mm from the radiographic apex. The tooth was next temporized with Teflon tape and Fuji TRIAGE. Four weeks later, after confirming the patient was asymptomatic and tooth mobility had decreased, the canal was obturated using EndoSequence Bioceramic Root Repair Material Fast Set Putty in 2 mm incremental layers to achieve a three-dimensional fill and create an apical plug to prevent gutta-percha extrusion, then backfilled in incremental layers of gutta-percha to the cementoenamel junction (CEJ). At the 8-month follow-up, the patient was asymptomatic, and the periodontal ligament (PDL) had no signs of periapical pathology. When teeth undergoing auto-transplantation procedures develop apical periodontitis, NSRCT can be implemented.
format Article
id doaj-art-4deb3558905b4046b06f1bffbfaa1daf
institution Kabale University
issn 2090-6455
language English
publishDate 2023-01-01
publisher Wiley
record_format Article
series Case Reports in Dentistry
spelling doaj-art-4deb3558905b4046b06f1bffbfaa1daf2025-02-03T06:47:22ZengWileyCase Reports in Dentistry2090-64552023-01-01202310.1155/2023/9389760Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical PeriodontitisChristopher M. Naglieri0Ellie Bash1Glen A. Karunanayake2Carlos H. R. Camargo3Takashi Komabayashi4Division of Comprehensive Oral Health - EndodonticsDivision of Comprehensive Oral Health - PeriodonticsDivision of Comprehensive Oral Health - EndodonticsDivision of Comprehensive Oral Health - EndodonticsDivision of Comprehensive Oral Health - EndodonticsAuto-transplantation is a procedure that replaces traumatized or congenitally missing teeth. While most auto-transplanted teeth are successfully integrated into recipient sites, the donor tooth may develop apical periodontitis, causing early failure. In the present case report, the periodontic resident performed the procedure on a 15-year-old male by selecting donor teeth #4 and #13 and transplanting them at recipient sites #29 and #20, respectively. After 6 weeks, the patient was referred to the endodontic resident for evaluation of tooth #20 due to symptom development. While one auto-transplanted tooth (donor tooth #4, recipient site #29) was successfully integrated, the other (donor tooth #13, recipient site #20) was unsuccessful: the patient was diagnosed with pulp necrosis and a chronic apical abscess. Because of the patient’s age, collaboration among periodontic, endodontic, and orthodontic residents/specialists informed the clinical decision to pursue non-surgical root canal treatment (NSRCT) rather than extraction. The canal was cleaned and shaped to a size #80 using copious irrigation of 2.5% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA) via the EndoVac Negative Pressure Irrigation system. The tooth was dried with paper points, and then calcium hydroxide was mixed with 2.5% NaOCl and placed with an amalgam carrier 2 mm from the radiographic apex. The tooth was next temporized with Teflon tape and Fuji TRIAGE. Four weeks later, after confirming the patient was asymptomatic and tooth mobility had decreased, the canal was obturated using EndoSequence Bioceramic Root Repair Material Fast Set Putty in 2 mm incremental layers to achieve a three-dimensional fill and create an apical plug to prevent gutta-percha extrusion, then backfilled in incremental layers of gutta-percha to the cementoenamel junction (CEJ). At the 8-month follow-up, the patient was asymptomatic, and the periodontal ligament (PDL) had no signs of periapical pathology. When teeth undergoing auto-transplantation procedures develop apical periodontitis, NSRCT can be implemented.http://dx.doi.org/10.1155/2023/9389760
spellingShingle Christopher M. Naglieri
Ellie Bash
Glen A. Karunanayake
Carlos H. R. Camargo
Takashi Komabayashi
Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
Case Reports in Dentistry
title Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
title_full Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
title_fullStr Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
title_full_unstemmed Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
title_short Successful Non-Surgical Root Canal Treatment on Auto-Transplanted Maxillary Premolar with Apical Periodontitis
title_sort successful non surgical root canal treatment on auto transplanted maxillary premolar with apical periodontitis
url http://dx.doi.org/10.1155/2023/9389760
work_keys_str_mv AT christophermnaglieri successfulnonsurgicalrootcanaltreatmentonautotransplantedmaxillarypremolarwithapicalperiodontitis
AT elliebash successfulnonsurgicalrootcanaltreatmentonautotransplantedmaxillarypremolarwithapicalperiodontitis
AT glenakarunanayake successfulnonsurgicalrootcanaltreatmentonautotransplantedmaxillarypremolarwithapicalperiodontitis
AT carloshrcamargo successfulnonsurgicalrootcanaltreatmentonautotransplantedmaxillarypremolarwithapicalperiodontitis
AT takashikomabayashi successfulnonsurgicalrootcanaltreatmentonautotransplantedmaxillarypremolarwithapicalperiodontitis