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“The success of autotransplantation of teeth depends on indication and technique”

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Dr Mitsuhiro Tsukiboshi presenting at ROOTS SUMMIT 2024. (Image: Dental Tribune International)
Iveta Ramonaite, Dental Tribune International

Iveta Ramonaite, Dental Tribune International

Sat. 11. May 2024

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Autotransplantation of teeth (ATT) is a promising approach that offers a blend of aesthetic, functional and economic benefits for patients with missing or compromised teeth. However, this therapy may be overlooked as a viable option for tooth replacement. In this interview with Dental Tribune International, ROOTS SUMMIT 2024 speaker Dr Mitsuhiro Tsukiboshi, a pioneering figure in dental traumatology and tooth transplantation, delves into the nuances of ATT, addresses common misconceptions and explores possible advancements in treatment fuelled by technological developments.

Dr Tsukiboshi, you’ve had a distinguished career since earning your PhD in dental materials in 1981. What initially drew you to the field of ATT?
I didn’t have any definite prospects as a dentist just after graduating from dental school. I started a general dental practice when I was 29 years old, but I was initially at a loss about integrating periodontal and endodontic care effectively, and naturally, my interest shifted to these two issues. I eventually became interested in healing processes after treatment, such as healing of the periodontal ligament and pulp. However, owing to my limited knowledge of dental trauma, I sometimes overtreated cases. Fortunately, I encountered Dr Jens Ove Andreasen, who was the father of dental traumatology and tooth transplantation. My work and interest as a dentist changed rapidly and vividly after that.

What role does ATT play in modern dentistry?
The role of ATT is to treat missing teeth or hopeless teeth with natural teeth aesthetically, functionally and predictably, mainly in young patients, at lower cost.

Are there any common misconceptions about ATT that you would like to address?
I think there are two misconceptions. Many dentists still believe that the success rate of ATT is low, whereas others believe it to be extremely high. I think both assumptions are wrong. The success of ATT depends on indication and technique, and these are related to the experience and knowledge of the dental professional performing the procedure.

“Many dentists still believe that the success rate of ATT is low, whereas others believe it to be extremely high.”

What are the most significant benefits of ATT, especially for younger patients, and what are some key factors that dental professionals should consider for ensuring the viability of transplanted teeth?
The most significant benefit is that the transplanted tooth can stimulate and maintain bone around it. It can move orthodontically and naturally cooperate with the other teeth in the mouth. The critical key to success is the periodontal ligament remaining on the root surface of the transplant. The patient’s age, root form and extra-oral time during surgery are important as well.

You have mentioned elsewhere that ATT can be particularly advantageous in scenarios where the recipient sites pose challenges for implant placement. Can you elaborate on that?
In implant therapy, a bony defect of the recipient site must be augmented before or during surgery. However, in the case of ATT, compromised recipient sites can be repaired naturally owing to the presence of the periodontal ligament on the transplant. Sinus lift performed concurrently with ATT offers significant benefits.

How do you envision the future of ATT in dentistry? Are there new techniques or materials on the horizon that could further enhance the success rates of ATT?
Like other areas of dental treatment, the developments in 3D technology offer advantages in ATT. 3D analysis before treatment, 3D plastic replicas and surgical guides, for example, are being used in ATT and seem to be leading to higher success rates. 3D analysis gives us the insight necessary to determine whether ATT is indicated or not, and 3D technology reduces the extra-oral time of the donor tooth and periodontal ligament injury during the try-in procedure.

What advice would you give to dental practitioners who are new to ATT and wish to integrate it into their practices?
I would like to say that success depends on the indication, the age of the patient, the stage of root development, the form of the roots and the technique used. I recommend that dentists start ATT with immature donor teeth.

At the end of May, I’ll be publishing a revised second edition of my book Autotransplantation of Teeth in English, in which aspects such as the biological principles, techniques and indications will be discussed in depth. Reading the book will give dental professionals who are interested in ATT a good foundation.

    Participants are happy to be at this year’s meeting and reconnect with fellow dentists. (All images: Dental Tribune International)
    Participants are happy to be at this year’s meeting and reconnect with fellow dentists. (All images: Dental Tribune International)

    ROOTS SUMMIT 2024 was being held from 9 to 12 May at the Eugenides Foundation in Athens.
    ROOTS SUMMIT 2024 was being held from 9 to 12 May at the Eugenides Foundation in Athens.

    Thanks to all the speakers and attendees for making ROOTS SUMMIT 2024 such a special event.
    Thanks to all the speakers and attendees for making ROOTS SUMMIT 2024 such a special event.

    ROOTS SUMMIT commenced with a series of hands-on courses on Thursday, providing dental professionals with an opportunity to refine their techniques and delve into the latest advancements in endodontic care. Pictured from left: Dr Freddy Belliard, co-chairman of the event, and workshop presenter Dr Hugo Sousa Dias.
    ROOTS SUMMIT commenced with a series of hands-on courses on Thursday, providing dental professionals with an opportunity to refine their techniques and delve into the latest advancements in endodontic care. Pictured from left: Dr Freddy Belliard, co-chairman of the event, and workshop presenter Dr Hugo Sousa Dias.

    Dr Hugo Sousa Dias led a hands-on course focused on managing narrow and curved canals, including S-shaped ones, using the martensitic file system to ensure safe and effective outcomes.
    Dr Hugo Sousa Dias led a hands-on course focused on managing narrow and curved canals, including S-shaped ones, using the martensitic file system to ensure safe and effective outcomes.

    Dr Freddy Belliard (left), co-chairman of the event, and workshop presenter Dr Marian Fanica.
    Dr Freddy Belliard (left), co-chairman of the event, and workshop presenter Dr Marian Fanica.

    Dr Marian Fanica during his hands-on course on post-endodontic treatment of teeth with large areas of destruction.
    Dr Marian Fanica during his hands-on course on post-endodontic treatment of teeth with large areas of destruction.

    Hands-on course attendees learned about Encore D/C (Centrix), a dual-curing core build-up composite.
    Hands-on course attendees learned about Encore D/C (Centrix), a dual-curing core build-up composite.

    Prof. Gianluca Gambarini presented a workshop on the newest developments in the design, motion and clinical application of instruments, aimed at improving the efficacy and safety of root canal preparation, offering a cost-effective approach to NiTi rotary instrumentation.
    Prof. Gianluca Gambarini presented a workshop on the newest developments in the design, motion and clinical application of instruments, aimed at improving the efficacy and safety of root canal preparation, offering a cost-effective approach to NiTi rotary instrumentation.

    Hands-on courses captured the attention of attendees and brought new procedural possibilities to the forefront.
    Hands-on courses captured the attention of attendees and brought new procedural possibilities to the forefront.

    The most current issue of roots magazine, including a ROOTS SUMMIT special highlighting the programme, lecture abstracts, speaker bios and interviews, was available to attendees at the event.
    The most current issue of roots magazine, including a ROOTS SUMMIT special highlighting the programme, lecture abstracts, speaker bios and interviews, was available to attendees at the event.

    From left: ROOTS SUMMIT speakers Dr Ruth Pérez-Alfayate and Dr Rajiv Patel.
    From left: ROOTS SUMMIT speakers Dr Ruth Pérez-Alfayate and Dr Rajiv Patel.

    Dr David E. Jaramillo, scientific chairman, and Dr Freddy Belliard and Stephen Jones, co-chairmen at the opening ceremony on Friday morning.
    Dr David E. Jaramillo, scientific chairman, and Dr Freddy Belliard and Stephen Jones, co-chairmen at the opening ceremony on Friday morning.

    ROOTS SUMMIT 2024 Scientific Chairman Dr David E. Jaramillo opened the event.
    ROOTS SUMMIT 2024 Scientific Chairman Dr David E. Jaramillo opened the event.

    Prof. Matthias Zehnder was the first speaker and presented on “Irrigation and disinfection of the root canal”.
    Prof. Matthias Zehnder was the first speaker and presented on “Irrigation and disinfection of the root canal”.

    Steve Jones and Dr Freddy Belliard.
    Steve Jones and Dr Freddy Belliard.

    From left: Steve Jones, Dr David E. Jaramillo and Dr Freddy Belliard.
    From left: Steve Jones, Dr David E. Jaramillo and Dr Freddy Belliard.

    From left: Steve Jones, Dr Ruth Pérez-Alfayate, Dr David E. Jaramillo and Dr Freddy Belliard.
    From left: Steve Jones, Dr Ruth Pérez-Alfayate, Dr David E. Jaramillo and Dr Freddy Belliard.

    From left: Dr David E. Jaramillo, Dr Freddy Belliard, Prof. Matthias Zehnder and Steve Jones.
    From left: Dr David E. Jaramillo, Dr Freddy Belliard, Prof. Matthias Zehnder and Steve Jones.

    From left: Dr David E. Jaramillo, ROOTS SUMMIT speaker Dr Josiane Almeida, Dr Freddy Belliard and Steve Jones.
    From left: Dr David E. Jaramillo, ROOTS SUMMIT speaker Dr Josiane Almeida, Dr Freddy Belliard and Steve Jones.

    EdgeEndo offers endodontic files, points, obturators and verifiers.
    EdgeEndo offers endodontic files, points, obturators and verifiers.

    Attendees in conversation at the COLTENE booth.
    Attendees in conversation at the COLTENE booth.

    ROOTS SUMMIT attendee trying out the cordless endo motor CanalPro X-Move from COLTENE.
    ROOTS SUMMIT attendee trying out the cordless endo motor CanalPro X-Move from COLTENE.

    Centrix booth at ROOTS SUMMIT 2024.
    Centrix booth at ROOTS SUMMIT 2024.

    Attendee trying out a surgical magnification device from Zumax Medical.
    Attendee trying out a surgical magnification device from Zumax Medical.

    ROOTS SUMMIT attendee getting more information on a surgical loupe from Zumax Medical.
    ROOTS SUMMIT attendee getting more information on a surgical loupe from Zumax Medical.

    The XP-endo Rise Shaper from FKG Dentaire has a redesigned tip that increases predictability and control.
    The XP-endo Rise Shaper from FKG Dentaire has a redesigned tip that increases predictability and control.

    Dr Ruth Pérez-Alfayate during her presentation on complex diagnosis in endodontics.
    Dr Ruth Pérez-Alfayate during her presentation on complex diagnosis in endodontics.

    Dr Rajiv Patel giving a presentation on dental trauma.
    Dr Rajiv Patel giving a presentation on dental trauma.

    Dr Rajiv Patel.
    Dr Rajiv Patel.

    ROOTS SUMMIT 2024_55
    ROOTS SUMMIT 2024_55

    ROOTS SUMMIT 2024_56
    ROOTS SUMMIT 2024_56

    ROOTS SUMMIT 2024_57
    ROOTS SUMMIT 2024_57

    Prof. Aviad Tamse discussing vertical root fractures in endodontically treated teeth.
    Prof. Aviad Tamse discussing vertical root fractures in endodontically treated teeth.

    Prof. Laura Ceballos presenting her lecture, titled
    Prof. Laura Ceballos presenting her lecture, titled "Restoration of endodontically treated teeth: Increasing predictability and reducing limits”.

    In addition to the scientific lectures, ROOTS SUMMIT 2024 featured a poster presentation.
    In addition to the scientific lectures, ROOTS SUMMIT 2024 featured a poster presentation.

    ROOTS SUMMIT attendee trying out a dental surgical microscope from Seiler.
    ROOTS SUMMIT attendee trying out a dental surgical microscope from Seiler.

    ROOTS Summit 2024_62
    ROOTS Summit 2024_62

    Dr Josiane Almeida is a researcher and lecturer in the Department of Endodontics at the University of Southern Santa Catarina and Federal University of Santa Catarina in Brazil.
    Dr Josiane Almeida is a researcher and lecturer in the Department of Endodontics at the University of Southern Santa Catarina and Federal University of Santa Catarina in Brazil.

    Attendees mingling with industry experts.
    Attendees mingling with industry experts.

    Aesthetic outcome of single tooth replacement in the aesthetic zone was the topic Dr Juan Mesquida's presentation.
    Aesthetic outcome of single tooth replacement in the aesthetic zone was the topic Dr Juan Mesquida's presentation.

    Dr Mitsuhiro Tsukiboshi believes that the success of autotransplantation of teeth depends on indication and technique.
    Dr Mitsuhiro Tsukiboshi believes that the success of autotransplantation of teeth depends on indication and technique.

    Member case presentations.
    Member case presentations.

    Member case presentations.
    Member case presentations.

    As social engagement plays a crucial role in the ROOTS SUMMIT community, the organisers planned a seaside event on Saturday evening at the Ark restaurant, one of the highest-rated locales in Greece for six years running.
    As social engagement plays a crucial role in the ROOTS SUMMIT community, the organisers planned a seaside event on Saturday evening at the Ark restaurant, one of the highest-rated locales in Greece for six years running.

    Attendees were treated to an open bar with classic cocktails and inventive Greek cuisine throughout the evening.
    Attendees were treated to an open bar with classic cocktails and inventive Greek cuisine throughout the evening.

    The get-together offered attendees the opportunity to relax and interact.
    The get-together offered attendees the opportunity to relax and interact.

    The organisers of ROOTS SUMMIT with team members of Dental Tribune International, co-organiser of the event.
    The organisers of ROOTS SUMMIT with team members of Dental Tribune International, co-organiser of the event.

    Dr Spyros Floratos held a lecture on the rationale for the management of complex, borderline cases in endodontics.
    Dr Spyros Floratos held a lecture on the rationale for the management of complex, borderline cases in endodontics.

    Dr Ali Vahdati giving a lecture on the management of challenges and mishaps associated with radiographic examination and interpretation in endodontics.
    Dr Ali Vahdati giving a lecture on the management of challenges and mishaps associated with radiographic examination and interpretation in endodontics.

    Dr Antonis Chaniotis during his lecture, titled
    Dr Antonis Chaniotis during his lecture, titled "Root canal blockage management: Ledges, bricks and broken tips”.

    Participants are happy to be at this year’s meeting and reconnect with fellow dentists. (All images: Dental Tribune International)
    ROOTS SUMMIT 2024 was being held from 9 to 12 May at the Eugenides Foundation in Athens.
    Thanks to all the speakers and attendees for making ROOTS SUMMIT 2024 such a special event.
    ROOTS SUMMIT commenced with a series of hands-on courses on Thursday, providing dental professionals with an opportunity to refine their techniques and delve into the latest advancements in endodontic care. Pictured from left: Dr Freddy Belliard, co-chairman of the event, and workshop presenter Dr Hugo Sousa Dias.
    Dr Hugo Sousa Dias led a hands-on course focused on managing narrow and curved canals, including S-shaped ones, using the martensitic file system to ensure safe and effective outcomes.
    Dr Freddy Belliard (left), co-chairman of the event, and workshop presenter Dr Marian Fanica.
    Dr Marian Fanica during his hands-on course on post-endodontic treatment of teeth with large areas of destruction.
    Hands-on course attendees learned about Encore D/C (Centrix), a dual-curing core build-up composite.
    Prof. Gianluca Gambarini presented a workshop on the newest developments in the design, motion and clinical application of instruments, aimed at improving the efficacy and safety of root canal preparation, offering a cost-effective approach to NiTi rotary instrumentation.
    Hands-on courses captured the attention of attendees and brought new procedural possibilities to the forefront.
    The most current issue of roots magazine, including a ROOTS SUMMIT special highlighting the programme, lecture abstracts, speaker bios and interviews, was available to attendees at the event.
    From left: ROOTS SUMMIT speakers Dr Ruth Pérez-Alfayate and Dr Rajiv Patel.
    Dr David E. Jaramillo, scientific chairman, and Dr Freddy Belliard and Stephen Jones, co-chairmen at the opening ceremony on Friday morning.
    ROOTS SUMMIT 2024 Scientific Chairman Dr David E. Jaramillo opened the event.
    Prof. Matthias Zehnder was the first speaker and presented on “Irrigation and disinfection of the root canal”.
    Steve Jones and Dr Freddy Belliard.
    From left: Steve Jones, Dr David E. Jaramillo and Dr Freddy Belliard.
    From left: Steve Jones, Dr Ruth Pérez-Alfayate, Dr David E. Jaramillo and Dr Freddy Belliard.
    From left: Dr David E. Jaramillo, Dr Freddy Belliard, Prof. Matthias Zehnder and Steve Jones.
    From left: Dr David E. Jaramillo, ROOTS SUMMIT speaker Dr Josiane Almeida, Dr Freddy Belliard and Steve Jones.
    EdgeEndo offers endodontic files, points, obturators and verifiers.
    Attendees in conversation at the COLTENE booth.
    ROOTS SUMMIT attendee trying out the cordless endo motor CanalPro X-Move from COLTENE.
    Centrix booth at ROOTS SUMMIT 2024.
    Attendee trying out a surgical magnification device from Zumax Medical.
    ROOTS SUMMIT attendee getting more information on a surgical loupe from Zumax Medical.
    The XP-endo Rise Shaper from FKG Dentaire has a redesigned tip that increases predictability and control.
    Dr Ruth Pérez-Alfayate during her presentation on complex diagnosis in endodontics.
    Dr Rajiv Patel giving a presentation on dental trauma.
    Dr Rajiv Patel.
    ROOTS SUMMIT 2024_55
    ROOTS SUMMIT 2024_56
    ROOTS SUMMIT 2024_57
    Prof. Aviad Tamse discussing vertical root fractures in endodontically treated teeth.
    Prof. Laura Ceballos presenting her lecture, titled
    In addition to the scientific lectures, ROOTS SUMMIT 2024 featured a poster presentation.
    ROOTS SUMMIT attendee trying out a dental surgical microscope from Seiler.
    ROOTS Summit 2024_62
    Dr Josiane Almeida is a researcher and lecturer in the Department of Endodontics at the University of Southern Santa Catarina and Federal University of Santa Catarina in Brazil.
    Attendees mingling with industry experts.
    Aesthetic outcome of single tooth replacement in the aesthetic zone was the topic Dr Juan Mesquida's presentation.
    Dr Mitsuhiro Tsukiboshi believes that the success of autotransplantation of teeth depends on indication and technique.
    Member case presentations.
    Member case presentations.
    As social engagement plays a crucial role in the ROOTS SUMMIT community, the organisers planned a seaside event on Saturday evening at the Ark restaurant, one of the highest-rated locales in Greece for six years running.
    Attendees were treated to an open bar with classic cocktails and inventive Greek cuisine throughout the evening.
    The get-together offered attendees the opportunity to relax and interact.
    The organisers of ROOTS SUMMIT with team members of Dental Tribune International, co-organiser of the event.
    Dr Spyros Floratos held a lecture on the rationale for the management of complex, borderline cases in endodontics.
    Dr Ali Vahdati giving a lecture on the management of challenges and mishaps associated with radiographic examination and interpretation in endodontics.
    Dr Antonis Chaniotis during his lecture, titled

Editorial note:

Dr Mitsuhiro Tsukiboshi gave a lecture titled “Autotransplantation of teeth” at ROOTS SUMMIT 2024 on 11 May from 3:30 p.m. to 5:00 p.m. More information about the event can be found on the
Topics:
Restorative Dentistry Endodontics Periodontology Dental Implantology
Tags:
Dental caries Dental surgery Dental trauma Endodontics Implant therapy Periodontal ligament Periodontics Pulp Tooth transplantation
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