title: Tooth autotransplantation in a free iliac crest graft for prosthetic reconstruction.
abstract: This report documents successful tooth autotransplantation to a free iliac crest graft in an exemplar case. A 14-year-old male patient was operated thrice with increasing amounts of resection for recurrent odontogenic myxoma. When mandibular continuity resection finally was performed, a free iliac crest block autotransplant was used for reconstruction. Upon metal removal 5 months later, 3 wisdom teeth with two-thirds complete root development were transplanted to the free graft and retained by fixed orthodontic appliances including skeletal anchorage with orthodontic microscrews. Tooth graft taking was awaited for 8 weeks with retention. Following undisturbed healing without occlusal forces, 6 months of orthodontic treatment intentionally extruded the autotransplanted teeth to antagonist contact. The third and most dorsal tooth became mobile after 3 months and was lost. The surviving 2 teeth were fitted by a prosthetic bridge as extrusion into the occlusal plane was not completely successful. This exemplar case shows benefit of tooth autotransplants in selected cases of jaw reconstruction with distal bone autotransplants as alternative to dental titanium implants and suprastructures. Orthodontic microscrews can moreover support tooth movement and positioning as anchorage device in altered anatomy.
authors.affiliation: Maxillofacial and Plastic-Facial Surgery, the Frankfurt University Medical Centre, Frankfurt, Germany. c.landes@lycos.com
authors.forename: Constantin A
authors.initials: CA
authors.lastname: Landes
authors.forename: Bettina
authors.initials: B
authors.lastname: Glasl
authors.forename: Björn
authors.initials: B
authors.lastname: Ludwig
authors.forename: Jörg
authors.initials: J
authors.lastname: Rieger
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation; D003830:Denture, Partial, Fixed; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery*; D008964:Molar, Third / Q000637:transplantation*; D009232:Myxoma / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009808:Odontogenic Tumors / Q000601:surgery*; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation; D009967:Orthodontic Appliances; D050793:Orthodontic Extrusion