Ask Us∗

Send your scientific questions to “Ask Us,” AJO-DO, University of Washington, Department of Orthodontics, D-569, HSC Box 357446, Seattle, WA 98195-7446 or, via the Internet, to dlturpin@aol.com. Include your name, mailing address, and e-mail address. We will send selected questions to a few of our expert reviewers for the answers. Questions and answers will be published together in future issues of the Journal.

Q Why are orthodontists in the United States reluctant to include the autotransplantation of permanent teeth when planning treatment for patients with 1 or 2 missing teeth?

A A number of years ago, I shared my experiences on tooth transplantation with a group of colleagues visiting from the United States who apparently considered autotransplantation to be a fascinating treatment option. They commented, however, that they would be reluctant to recommend transplantation to their own patients because of the risk of litigation if the treatment failed. Hesitation to advocate and use a treatment option that is not an established method in one's own environment might explain why this procedure is so seldom considered in the United States.

Another reason could be that clinicians have underestimated the need for careful surgery and the time necessary to transplant teeth. Consequently, failures might have occurred that had an impact on their willingness to make another attempt. Transplantation is not a quick fix, but neither is it more complicated than other procedures performed by oral surgeons and periodontists. Descriptions of the surgical procedure are available,1, 2 and, if adhered to in patients with good indications for transplantation,3 high survival and success rates can be expected.4

No commercial interests support measures to make tooth transplantation more available, such as companies arranging training courses in the surgical procedure for implants. Treatment must be initiated by professionals, because there is no demand for a treatment option with which the public is unfamiliar. Orthodontists would generally be the most competent professionals to identify available donor teeth. Because overall occlusal status must be assessed, the orthodontist should be considered a key person in planning, referring, and coordinating treatment that includes transplantation.

*The viewpoints expressed are solely those of the author(s) and do not reflect those of the editor(s), the publisher(s), or the Association.

Am J Orthod Dentofacial Orthop 2003;123:18A