Root Elongation After Autotransplantation in 58 Transplanted Premolars: The Radiographic Width of the Apex as a Predictor

Kees J H van Westerveld; Jop P Verweij; Marta Fiocco; Gertjan Mensink; J P Richard van Merkesteyn

doi:10.1016/j.joms.2019.02.019

Root Elongation After Autotransplantation in 58 Transplanted Premolars: The Radiographic Width of the Apex as a Predictor

J Oral Maxillofac Surg. 2019 Jul;77(7):1351-1357. doi: 10.1016/j.joms.2019.02.019. Epub 2019 Feb 20.

Authors

Kees J H van Westerveld¹, Jop P Verweij², Marta Fiocco³, Gertjan Mensink⁴, J P Richard van Merkesteyn⁵

Affiliations

¹ Researcher, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, the Netherlands.
² Resident Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, the Netherlands.
³ Associate Professor, Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden; Mathematical Institute, Leiden University, Leiden, the Netherlands.
⁴ Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden; Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, the Netherlands.
⁵ Maxillofacial Surgeon, Professor, and Department Head, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: J.P.R.van_Merkesteyn@lumc.nl.

PMID: 30878594
DOI: 10.1016/j.joms.2019.02.019

Abstract

Purpose: Autotransplantation of premolars with incomplete root development is a reliable treatment option for tooth replacement. Nevertheless, little is known about root development after transplantation of teeth. The aim of this study was to evaluate preoperative root development stage and radiographic width of the apex as predictors for root elongation after autotransplantation.

Materials and methods: A retrospective cohort study was implemented and composed of patients who underwent autotransplantation of at least 1 premolar. Using panoramic radiographs (orthopantomograms), calibrated measurements were taken to record the root development stage of the donor tooth, width of the apex, and root length of the transplanted tooth.

Results: Forty-five patients (58 transplants) were included. Mean follow-up time was 12 months (range, 4 to 26 months). Fifty-three transplanted teeth (91.4%) showed root elongation. Mean root elongation at end of follow-up was 1.9 mm (range, 0.0 to 4.3 mm). A wide-open apex before transplantation was significantly associated with root elongation after autotransplantation (P < .01). Root development stage (P = .82) did not show significant associations with root elongation.

Conclusions: A wide-open apex (>2.0 mm) is an important predictor of root elongation after autotransplantation of premolars. This might be a better predictor for root development than preoperative root development stage.

MeSH terms

Bicuspid*
Follow-Up Studies
Humans
Odontogenesis*
Retrospective Studies
Tooth Root*
Transplantation, Autologous*
Treatment Outcome