Utilization of the remaining periodontal ligament and tooth repositioning for optimized periodontal healing: a case series
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Tooth autotransplantation and surgical extrusion can preserve natural dentition, but outcomes are often compromised under nonideal periodontal conditions. The viability of the periodontal ligament (PDL) is essential for regeneration. This case series introduces a zonebased approach of donor–recipient interfaces: zone I (intact PDL and bone), II (one intact, one damaged), and III (both damaged). Three cases involving hemisection, intentional replantation with rotation, and autotransplantation were managed by repositioning the tooth to maximize zones I and II while minimizing zone III. After 5–12 months, probing depths decreased by 2–4 mm, Periotest values improved, and radiographs confirmed bone stability. This approach consistently transformed unfavorable zone III interfaces into more biologically favorable contacts. A zone-based repositioning strategy leveraging residual PDL may promote periodontal healing even under compromised conditions. Further prospective studies are needed to validate this system.
Abstract
Tooth autotransplantation and surgical extrusion can preserve natural dentition, but outcomes are often compromised under nonideal periodontal conditions. The viability of the periodontal ligament (PDL) is essential for regeneration. This case series introduces a zonebased approach of donor–recipient interfaces: zone I (intact PDL and bone), II (one intact, one damaged), and III (both damaged). Three cases involving hemisection, intentional replantation with rotation, and autotransplantation were managed by repositioning the tooth to maximize zones I and II while minimizing zone III. After 5–12 months, probing depths decreased by 2–4 mm, Periotest values improved, and radiographs confirmed bone stability. This approach consistently transformed unfavorable zone III interfaces into more biologically favorable contacts. A zone-based repositioning strategy leveraging residual PDL may promote periodontal healing even under compromised conditions. Further prospective studies are needed to validate this system.