Autotransplantation for posterior mandibular rehabilitation: Replacing a non-restorable first molar

Introduction: Tooth autotransplantation represents a valuable treatment option in young patients, particularly when conventional prosthetic or implant treatment is contraindicated due to ongoing craniofacial growth. It preserves alveolar bone, restores function, avoids prosthetic intervention, particularly relevant in growing patients.

Backgroud and aim: To demonstrate the use of mandibular third molar autotransplantation as a treatment option for a non-restorable first molar in a growing patient.

Materials and Methods: A 16-year-old patient presented with a severely destructed and non-restorable mandibular right first molar (46) with periapical lesions affecting both roots. Due to the patient’s age and the presence of a suitable donor tooth, autotransplantation was selected as a treatment option.
Following atraumatic extraction of the mandibular right first molar (46), the mandibular right third molar (48), with favorable root morphology and incomplete root development, was carefully extracted and transplanted into the recipient site. The transplanted tooth was stabilized with a fiber-reinforced composite splint for one month.

Results: Clinical follow-up showed satisfactory positioning, absence of pathological mobility, and satisfactory healing. Follow-up is ongoing, with further vitality testing and radiographic evaluation are planned.

Conclusion: Autotransplantation can represent a biologically sound and cost-effective treatment option in carefully selected cases for young patients with non-restorable teeth.