하악 측절치 결손과 하악 제1대구치 유착을 보이는 환자에서 자가치아이식을 이용한 치험례

Autotransplantation in a Patient with Mandibular Lateral Incisor Agenesis and Ankylosed First Molar: A Case Report

This case report presents a 14-year-old female patient with skeletal Class I malocclusion, bilateral agenesis of the mandibular lateral incisor, and ankylosis of the left mandibular first molar. Her chief complaint was an unesthetic facial profile due to lip protrusion and multiple missing teeth in the mandible. Treatment involved extraction of the maxillary first premolars to reduce upper lip protrusion and resolve the large overjet. One extracted premolar was subsequently autotransplanted to replace the left mandibular canine, following substitution of the lateral incisor by the canine in the left mandibular quadrant. For successful autotransplantation, alveolar bone grafting was performed after orthodontic space preparation at the recipient site. The donor tooth was transplanted with a 90-degree rotation, followed by endodontic treatment and finalized with prosthetic rehabilitation. The transplanted tooth remained functional and clinically stable throughout the 5-year follow-up, without any signs of external root resorption or failure. After treatment, upper lip protrusion was resolved, resulting in an improved facial profile. Adequate anterior and posterior occlusion was achieved without the need for implant restoration. The treatment result was stable at the 1-year follow-up. This case highlights the potential of autotransplantation of a fully developed tooth as a viable alternative to implant restoration when combined with comprehensive orthodontic treatment.