Evaluation of the effect of extraoral apicoectomy and retrograde filling for the sealing of the root canal system of mature auto-transplantation teeth

Objective: This study aimed to investigate the effectiveness and feasibility of the use of extra-oral apicoectomy combined with retrograde filling for the sealing of root canal system without root canal therapy in the process of autotransplantation of tooth（ATT） .Materials and methods: Patients receiving autologous tooth transplantation in the Department of Oral Surgery, Hospital of Stomatology, Wuhan University from 2019 to 2020 were screened. A total 22 patients were included. All the roots of the donor tooth were fractured during tooth extraction, and root canal therapy was not performed temporarily after repairing the broken end and retrograde filling with iRoot BP plus. The periodontal status of the donor teeth 1–2 years after operation was studied, and CBCT was used to assess the presence of ankylosis, internal or external resorption of tooth, periodontitis, periapical periodontitis and omission of canal closure. Results: 22 transplanted teeth of 22 cases were all capable of chewing, and 4 of them had adverse clinical or radiographic findings. Results show a retention rate of 100% and success rate of 81.8%. These figures are consistent with the success and retention rates of the traditional autotransplantation. 63.6% of patients were able to chew hard objects with the planted teeth, and 45.4% of the cases had food impaction.the chewing efficiency of the patient's transplanted teeth side accounted for an average of 82.0% on the healthy side. Conclusion: The extra-oral apicoectomy combined with retrograde filling of the transplanted teeth yielded good results．Clinical Revelance: In some special cases such as when the complex root canal system of the donor teeth cannot guarantee perfect root canal therapy, extra-oral apicoectomy and retrograde filling to seal the root canal system may be an alternative for patients with autogenous tooth transplantation.