Third Molar Transplant

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Report of a Case

C.Q., a 21 year old female, was referred by her dentist to evaluate her mandibular first molars. She stated that 1265she has been having problems with these teeth for several years. Teeth #’s 19 and 30 were previously treated with root canal therapy and had posts and crowns. At the time of her visit on June 13, 2005, the teeth were asymptomatic. Radiographic exam revealed large radiolucencies around the roots of the mandibular first molars, as well as impacted mandibular third molars. (figure 1).

1266I recommended that C.Q. have her mandibular first molars extracted followed by transplantation of the mandibular third molars, which would need to be removed anyway, into the first molar sockets. She agreed to this and teeth #’s 19 and 30 were extracted on June 29, 2005. Healing occurred uneventfully and C.Q. returned to the office three weeks later, on July 20, 2005, and had the mandibular third molars removed and transplanted into the first molar sockets. (figure 2)

1267The teeth gradually stabilized and by September C.Q. was able to chew normally on her back teeth. In February 2006, however, transplanted tooth # 17 became infected and needed to be removed. Fortunately, tooth # 32 remained stable and a radiograph showed healthy bone around the roots. (figure 3). C.Q. was last seen in June 2006. Transplanted # 32 remained healthy and she was to have an implant placed into the area of # 19, but was lost to follow-up after getting married.Transplanting third molars into first molar sockets is a relatively uncommon procedure, as it requires specific conditions and timing. In my experience, I have had about 50% success.Please do not hesitate to call if you have any questions about this case or if you have a patient with a similar situation that might lend itself to this procedure