Wisdom Teeth Transplant for Tooth Loss

Overseen By Luis M De la Rosa, DDS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Cleveland Dental Institute

Disqualifiers: Systemic diseases, Pacemakers, Allergies, Smokers, Periodontal diseases

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 1 day

20 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method for replacing missing teeth using a patient's own wisdom teeth, known as autotransplantation (also called Tooth Autotransplantation or Dental Autotransplantation). It tests two approaches: one uses a special gel called PRF to aid healing, and the other does not. The goal is to determine if using wisdom teeth can serve as a viable alternative to traditional dentures or implants when standard treatments are not feasible. This trial may suit adults aged 20-50 with healthy wisdom teeth and no major health issues. As an unphased trial, it offers a unique opportunity to explore innovative dental solutions.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this autotransplantation technique is safe?

A previous study showed that using platelet-rich fibrin (PRF) in tooth autotransplantation improved healing and sped up recovery. Some research has examined tooth survival after transplantation, monitoring for complications over at least a year. These studies suggest that the procedure is generally well-tolerated. However, individual experiences can vary. Discuss potential risks with healthcare providers before joining a trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike traditional treatments for tooth loss that typically involve dental implants or bridges, the wisdom teeth transplant technique is unique because it uses the patient's own wisdom teeth for autotransplantation. Researchers are excited about this approach as it potentially offers a more natural and biocompatible solution, reducing the risk of rejection and the need for artificial materials. Additionally, one arm of the trial is exploring the use of platelet-rich fibrin (PRF) in conjunction with the transplantation, which may enhance healing and integration of the transplanted tooth, offering promising advancements over conventional methods.

What evidence suggests that autotransplantation could be effective for tooth loss?

This trial will compare two approaches to autotransplantation for tooth loss. One treatment arm involves autotransplantation with platelet-rich fibrin (PRF), while the other involves autotransplantation only. Studies have shown that moving a person's own tooth to a new spot in their mouth, especially when combined with PRF, can effectively treat tooth loss. PRF aids healing and reduces swelling, improving the success of the tooth transplant. Research indicates that using PRF in the procedure may speed recovery and enhance overall results. In short, adding PRF to the transplant process appears to make the treatment more effective by supporting healing and maintaining good blood flow to the area. These findings suggest a promising option for those unable to undergo regular dental treatments. ^{1 2 6 7 8}

Who Is on the Research Team?

Waleed Elmallah, DDS

Principal Investigator

Cleveland Dental

Ahmed Hashem, DDS

Principal Investigator

Cleveland Dental

Are You a Good Fit for This Trial?

This trial is for healthy adults aged 20-50 with immature wisdom teeth needing removal, who can follow study procedures and have no major health issues. It's not for those with systemic diseases affecting healing, pacemaker users, periodontal disease sufferers, medication allergy patients or active smokers.

Inclusion Criteria

I am between 20 and 50 years old.

Complying with the study procedures

Holding an Anesthesiologists classification of 1 or 2

Exclusion Criteria

Patients with pacemakers

I do not have any illnesses that could slow down my healing.

I have gum disease.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo autotransplantation of wisdom teeth, with or without Platelet Rich Fibrin

1 day

1 visit (in-person)

Follow-up

Participants are monitored for radiographic success of the transplanted teeth

52 weeks

Regular visits over one year

What Are the Treatments Tested in This Trial?

Interventions

• Autotransplantation

Trial Overview

The trial is testing the effectiveness of autotransplantation of wisdom teeth with and without Platelet Rich Fibrin (PRF), a substance that may aid healing. Participants will be randomly assigned to receive either just the tooth transplant or the transplant plus PRF.

How Is the Trial Designed?

Group I: Autotransplantation with PRF Experimental Treatment 1 Intervention

Group II: Autotrasplantation only Active Control 1 Intervention

Autotransplantation is already approved in European Union, United States, Canada for the following indications:

Approved in European Union as Tooth Autotransplantation for:

• Tooth loss due to trauma
• Tooth loss due to decay
• Tooth loss due to periodontal disease
• Congenitally missing teeth

Approved in United States as Autogenous Tooth Transplantation for:

• Tooth loss due to trauma
• Tooth loss due to decay
• Tooth loss due to periodontal disease
• Congenitally missing teeth

Approved in Canada as Dental Autotransplantation for:

• Tooth loss due to trauma
• Tooth loss due to decay
• Tooth loss due to periodontal disease
• Congenitally missing teeth

Who Is Running the Clinical Trial?

Cleveland Dental Institute

Lead Sponsor

Trials

6

Recruited

440+

Published Research Related to This Trial

A case report demonstrated successful autogenous tooth transplantation of an impacted tooth into the site of a decayed tooth, with 18 months of follow-up showing excellent healing and stability of the transplanted tooth.

Despite potential risks like root resorption, the procedure can achieve a high success rate when donor teeth are properly selected and managed, making it a viable treatment option for replacing missing teeth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autotransplantation. Gupta, S., Goel, M., Sachdeva, G., et al.[2020]

Autogenous tooth transplantation is a successful method for replacing missing teeth in young patients, providing both functional and aesthetic benefits by using a natural tooth instead of artificial options.

A case report demonstrated a successful third molar transplantation to replace a first molar, with a follow-up period of 9 years, supporting the viability of this technique in modern dental practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Third Molar Autotransplantation: An Alternative to Dental Implant - 9 Years Follow up of a Case. Kumar, S., Jain, M., Sogi, S., et al.[2021]

In a study involving over 20 patients, 90% of autotransplanted mandibular third molars were successful, demonstrating that this procedure is a viable option for replacing missing molars without immune reactions.

The study suggests that autotransplantation not only restores normal chewing function and periodontal healing but also presents a cost-effective alternative to other prosthetic rehabilitation methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Prospective Study on Autotransplantation of Mandibular Third Molars With Complete Root Formation. Dhar, S., Singh, G., Mishra, M., et al.[2023]

In a study of 182 autotransplanted teeth, the procedure demonstrated a low failure rate of 4.5% over a follow-up period of 2 to 60 months, indicating its effectiveness as a treatment for missing teeth.

The success of the transplants was significantly influenced by initial stability, with those showing better stability achieving more complete healing, while the average extraoral time of 7.58 minutes did not correlate with complications like root resorption or ankylosis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the prognosis and causes of failure in 182 cases of autogenous tooth transplantation. Kim, E., Jung, JY., Cha, IH., et al.[2022]

Dental autotransplantation can achieve a high success rate of over 90%, making it a reliable option for tooth replacement within the same patient.

In a case involving an 18-year-old patient, the successful autotransplantation of an immature third molar to replace a decayed first molar was attributed to the atraumatic surgical technique and the developmental stage of the donor tooth, with positive outcomes observed after 36 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autotransplantation of a mature mandibular third molar as alternative to dental implant placement: Case report. Tagliatesta, L., Guerri, F., Moscone, S., et al.[2021]

Autogenous tooth transplantation can be a successful alternative for replacing lost teeth, as demonstrated in two cases where third molars were successfully transplanted into new sites after extraction, with follow-ups showing positive outcomes after 3 to 5 years.

The procedure involved careful surgical techniques and endodontic treatment, suggesting that with proper case selection and management, this method can provide both aesthetic and functional benefits, making it a cost-effective option compared to traditional prosthetics and implants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autogenous transplantation of teeth with complete root formation: two case reports. Teixeira, CS., Pasternak, B., Vansan, LP., et al.[2016]

Autotransplantation of teeth has favorable long-term survival rates and can provide benefits such as maintaining a functioning periodontium and preserving alveolar bone volume, especially in growing patients.

Despite its advantages, autotransplantation is not widely practiced outside of Scandinavian countries, and this review aims to highlight factors influencing its success and promote its recognition as a viable treatment option for compromised teeth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autotransplantation: a viable treatment option for adolescent patients with significantly compromised teeth. Ong, D., Itskovich, Y., Dance, G.[2018]

Autogenous tooth transplantation has become a reliable option for tooth replacement, achieving high success rates when performed with careful patient selection and proper technique.

This procedure eliminates the need for implant-supported prosthetics, providing both aesthetic and functional benefits, as demonstrated in three case reports discussed in the article.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autogenous tooth transplantation: an alternative to dental implant placement? Clokie, CM., Yau, DM., Chano, L.[2004]

Autotransplantation of a fully formed third molar can be a successful alternative to dental implants for patients missing teeth, provided that the surgical technique is performed correctly.

Even if the autotransplantation fails, dental implants can still be placed afterward, making this approach a flexible option for tooth replacement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Autotransplantation: An Alternative to Dental Implants- Case Report With 4-Year Follow-Up. Kobayashi, T., Blatz, MB.[2019]

Citations

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11959680/

Tooth autotransplantation outcomes using platelet‐rich fibrin

Incorporating platelet‐rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment outcomes.

2.

aap.onlinelibrary.wiley.com

aap.onlinelibrary.wiley.com/doi/pdf/10.1002/cap.10287

Tooth autotransplantation outcomes using platelet‐rich fibrin

Incorporating platelet-rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment ...

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sciencedirect.com

sciencedirect.com/science/article/pii/S2772414X25000052

The use of platelet-rich fibrin in maintaining vascularity for ...

Platelet-rich fibrin (PRF) has characteristics that may improve the success of autotransplanted mature teeth by decreasing harmful inflammation and boosting ...

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researchgate.net

researchgate.net/publication/380294263_Tooth_autotransplantation_outcomes_using_platelet-rich_fibrin_A_promising_approach_case_study

(PDF) Tooth autotransplantation outcomes using platelet‐ ...

Incorporating platelet‐rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment outcomes.

5.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/38696612/

Tooth autotransplantation outcomes using platelet-rich fibrin

Incorporating platelet-rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment outcomes.

6.

link.springer.com

link.springer.com/article/10.1007/s00784-020-03673-y

A retrospective analysis of autotransplanted teeth including ...

To assess survival rates and frequency of complications for immature and mature autotransplanted teeth after at least 1 year in function.

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researchgate.net

researchgate.net/publication/394269868_Short-Term_Effects_of_Platelet-Rich_Plasma_on_the_Clinical_Outcomes_of_Dental_Autotransplantation_in_Teeth_with_Complete_and_Incomplete_Root_Development_A_Randomized_Cohort_Study

Short-Term Effects of Platelet-Rich Plasma on the Clinical ...

This study aimed to assess the short-term impact of platelet-rich plasma (PRP) on clinical outcomes in autotransplanted teeth with fully and ...

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pdfs.semanticscholar.org

pdfs.semanticscholar.org/1353/8f6ff25976943225bf5c31eae33a4ef940df.pdf

A Review of Autotransplantation Techniques and ...

The goal of autotransplantation of teeth (ATT) is to provide the patient with a functioning tooth to replace a missing one.