Rapid orthodontics via surgery: Multiple auto‐transplantations

Abstract

To use auto‐transplantation of a central incisor and canine and repositioning of a lateral incisor with corticotomy as an alternative to complex lengthy orthodontics and possible tooth loss.Following initial consultation in a joint orthodontic/oral surgery clinic in Guy's Hospital, the decision was made to carry out auto‐transplantation of the ectopic teeth under general anaesthesia. The procedure included extraction of retained primary teeth, auto‐transplantation of upper right permanent central incisor and canine, segmental osteotomy/corticotomy to reposition the lateral incisor, followed by splinting of the upper 3–3 for 6 weeks. The patient was reviewed multiple times over a 2.5‐year period and no signs of inflammation, ankylosis, sensitivity, root resorption, mobility or loss of vitality was noted.Auto‐transplantation is an underutilised technique despite being used for over 70 years. It does, however, have its limitations and there are several factors that can affect its success and predictability. This case highlights that it can be an excellent alternative to lengthy and difficult orthodontic treatment and resulted in avoidance of loss of teeth. This treatment method reduced time and cost to the NHS as well as improved the patient journey. It is important to work closely with colleagues and adopt a multidisciplinary approach to treatment planning and have an awareness for alternative treatment options that are available for joint orthodontic/oral surgery cases.Auto‐transplantation, in certain cases and conditions, can be very successful and save both patient and the NHS time and money. Greater awareness of this technique is required so that it can be offered more regularly as a treatment option.