INVITED SPEAKERS and ABSTRACTS

Autotransplantation of Teeth

Autotransplantation of teeth is today a well documented treatment method and is well suited for treatment of anterior tooth loss and tooth agenesis sites. Due to the unique osteogenic capacity of the graft, this procedure offers a treatment alternative, where both the lost tooth and the atrophied alveolar process can be replaced. Studies have demonstrated good long-term survival of these transplants, thus providing a realistic treatment alternative for tooth replacement in young individuals. Furthermore, this treatment procedure has its optimum of success in early childhood, a period where implants are definitively contraindicated. The key to successful tooth transplantation has been shown clinically and experimentally to be proper selection of grafts with adequate root development as well as the design of surgical techniques for atraumatic graft removal and graft insertion. These techniques will be presented and long-term prognosis will be presented in details.

Dr. Andreasen received his dental degree from the Royal Dental College, Copenhagen, in 1959. He did his postgraduate training in Oral and Maxillofacial Surgery at the University Hospital in Copenhagen, where he now is an associate Professor.

Dr. Andreasen has authored 350 publications and 11 textbooks, covering topics such as dental traumatology, tooth replantation and autotransplantation, tooth eruption and tooth impaction. In relation to traumatology the Textbook and Color Atlas of Dental Traumatology is now in its 4th edition and include 42 contributors.

He founded the interactive Dental Trauma Guide in 2008 which is now being used in 180 countries. It contains information of a series of prospective long term studies of all types of traumatic dental injuries carried out at the trauma center and Department of Oral and Maxillo-Facial Surgery as well as information from 50 animal experiments reproducing treatment scenarios of various dental traumas affecting primary as well as permanent teeth.

Dr. Andreasen has received four honorary doctorate degrees and has been an invited lecturer in 48 countries.

Transplantation of premolars to the anterior maxilla after severe traumatic injuries. Outcome with interdisciplinary orthodontics and esthetic dentistry

Autotransplantation of developing premolars to the maxillary anterior region is the preferred treatment alternative (and often the only realistic one) when one or several incisors have been lost after severe traumatic injuries in young persons. The outcome of interdisciplinary cooperation between orthodontics and prosthetic dentistry is equally dependent on both specialists. Noninvasive ultrathin enamel-bonded porcelain veneers (rather than porcelain crowns) on the transplanted premolars, as used by Dr. Sverker Toreskog for this lecture, and careful orthodontic management can restore the beauty and function of the natural dentition, even in the most difficult cases.

Bjorn U. Zachrisson, Oslo, Norway

Dr. Bjorn Zachrisson is Professor Emeritus in  the Department of Orthodontics at the University of Oslo, Norway. He maintained a private orthodontic practice from 1970 to 2010. He has published more than 275 scientific and clinical articles in international journals and textbooks in orthodontics, periodontics, traumatology, and general dentistry, and presented lectures and courses world wide.

These include numerous keynote lectures and pre- or postcongress courses at International Orthodontic Congresses. He has received many awards and honors from orthodontic societies in Europe, USA, Asia, Australia, and Africa,  including the Salzmann (1986), Steiner (1990), Friel  (1997),  Mershon  (1998), Northcroft (1999), Seward (2000), and Merrifield (2000) Lectures, and the Case (1996), the OERF (Orthodontic Education and Research Foundation) (1995), the Associated Journals of Europe (1997), Burstone (1999), Kokich/Shapiro Visiting Scholar (1999), 8th SIDO World (2001), Dewel (2003,2009) and Herren (2009)) Awards. In 2007, he  received the prestigious Ketcham Award and Jarabak Award from the American Association of Orthodontists.

Dr. Zachrisson is an Honorary Member of the Orthodontic Societies of Ireland, Republic of China (Taiwan), South Africa, Israel, Poland, Serbia and Montenegro, Peru, Czech Republic, Norway and The International Tweed Foundation, as well as of the Scandinavian Academy of Esthetic Dentistry, the Interdisciplinary Dental Society of the Caribbean, the Angle Society of Europe and the European Orthodontic Society. He is Associate Editor of the Journal of Clinical Orthodontics and a Member of the Editorial Boards of  several orthodontic and dental journals.

Tooth Transplantation at any age

authors: Dr. Dick Barendregt, Dr. Manfred Leunisse, Dr. Marcel Linssen

Since the first transplantations in the fifties of the last century, the advantages of the use of the patients own material were immediately clear. The disadvantage was that for a successful transplantation the root development of the donor teeth should be 2/3 to 3/4 of the fully developed length. In the literature transplantation of fully developed teeth has been described but the succesrate was not comparable to the transplantations with an open apex. Risk factors such as peri-apical inflammation and ankyloses were commonly described.

Since 2005 transplantation of fully developed teeth has been a routine procedure in Rotterdam with succes rates comparable to transplantation of teeth with open apices after 10 years. In this lecture a detailed description of this procedure will be presented. Topics which will be covered are indications for transplantation of fully developed teeth, timing for the endodontic treatment, moment of functional loading with orthodontic appliances and planning of the prothetic follow-up remodeling the transplanted tooth to the applicable location.

Dick Barendregt finished dental school in 1988 at the Rijksuniversiteit of Groningen. He worked as dentist in the Royal Dutch Navy en several private practices for a period of 5 years. In 1991 he started his Master of Science training in periodontology at the University of Amsterdam. After finishing his training in 1994 he worked as periodontist in 2 referral clinics  restricted to periodontology.

In 1996 he founded his own clinic in Rotterdam. In his clinic he works as a specialist in periodontology and implantology. The last 15 years the emphasis in patient treatment has been on the interdisciplinary planning (Proclin) together with endodontists, orthodontist, prosthetic dentist, dental technicians and oral surgeons. He is cofounder of the EndoRotterdam en PRORotterdam. Both clinics are closely related to the Clinic for Periodontology and are addresses for dentists to refer their patients to either endodontists or prosthetic/reconstructive specialists.

From 1995 to 2001 Dick Barendregt was on the board of the Dutch Society of Periodontology (NVvP) as treasurer. In this period he was the representative for the Netherlands with the EFP. After that period he joint the board of the Rotterdam Dentist Society for 10 years. Since 2009 he is member of the board of National Board on Quality of Postgraduate Dental Education.

Dick Barendregt works since 1994 with the Department of Periodontology at the University of Amsterdam and lectures in the Postgraduate Program in Periodontology. November 4th 2009 he received his PhD degree on his thesis “Probing around teeth”. He also lectures in both national and international meetings.

Transplantation of developing wisdom teeth – indications and outcomes

Developing wisdom teeth are often considered as donors in tooth transplantation, but the outcome is less predictable than premolar transplantation. This is related to more difficult surgical access and variable morphology of the third molars. Guidelines will be discussed for application of wisdom tooth transplantation in patients with congenitally missing teeth or to replace teeth with eruption disturbances. Also the surgical guidelines and orthodontic recommendations for selection of the best donors will be provided.

The presentation will also describe a simplified follow-up protocol for transplantation of developing teeth including critical aspects, which could lead to a sub-optimal outcome. Relevant studies related to transplantation of developing third molars will illustrate the reliable treatment outcome. The last part of the presentation will discuss the potential for regeneration of alveolar bone after transplantation of developing molars in contrast to of the alternative of dental implants. Comparison between dental implants and tooth transplants will be also highlighted.

Graduated as a dentist from the Dental Faculty in Warsaw, Poland. Research Fellow at the Department of Periodontology and Conservative Dentistry from 1991 until 1994. She finished a postgraduate training in orthodontics at the University in Oslo, Norway in 1997 then worked as a Research Fellow at the Orthodontic Department, Dental Faculty in Oslo until 2002.

In 2003 she was awarded a PhD from the University in Oslo for a thesis on autotransplantation of teeth.  For the publication from this work she received the American Journal of Orthodontics and Dentofacial Orthopedics Dewel Orthodontic Award in 2002. In 2014 she was awarded a habilitation in medical science from the Medical University in Warsaw, Poland on her work related to orthodontic treatment of patients with periodontitis and in 2015 she received the Award from the Rector of the Medical University in Warsaw.

Dr  Czochrowska was the President of the European Orthodontic Society and she hosted the Congress of the European Orthodontic Society in 2014 in Warsaw. She is the President of the Polish Orthodontic Society and the Member of the European Board of Orthodontists.

At present she is in private practice in Warsaw and is working at the Orthodontic Department in Warsaw. Her current research is based on the outcome of tooth transplantation and different aspects of interdisciplinary treatment.

Allograft bone augmentation of a traumatized or deficient alveolar ridge followed by tooth autotransplantation to replace missing teeth

Brief Synopsis:
The autotransplantation of teeth offers a natural tooth replacement for our growing patients that have missing, ankylosed or non-restorable teeth. However, a deficiency in the alveolar ridge due to development or trauma increases the complexity of this treatment modality.  This condition has usually required alveolar reconstruction with autologous bone prior to transplantation of the tooth.  This presentation will review a less invasive approach utilizing allograft bone for augmentation of the deficient alveolar ridge followed by successful tooth transplantation in our young patients.

Jim Janakievski received his D.D.S. from the University of Toronto, which was followed by a general practice residency. After several years in general practice, he completed his post-graduate training at the University of Washington, where he received a certificate in Periodontology with a M.S.D. degree and a fellowship in Prosthodontics. He continues to teach as an Affiliate Assistant Professor in the Department of Periodontology and has been invited to present at national and international conferences. Dr. Janakievski is a Diplomate of the American Board of Periodontology, and a member of the American Academy of Esthetic Dentistry.

He is a reviewer for several dental journals and has published in the area of dental implants and tooth autotransplantation. Dr. Janakievski maintains a private practice in Tacoma, Washington.

Emphasising the role of Orthodontics and the Versatility of Biological Auto transplantation

authors: Dr. Nadine Houghton, Dr. Hani Nazzal

The Leeds/Bradford autotransplantation team have developed a multidisciplinary approach for the management of anterior teeth with poor prognosis as a result of dental trauma. This involves bone management at the affected site followed by autotransplantation. Since the inception of this programme, we have placed over 180 transplants using the multidisciplinary team comprising of paediatric dentistry, orthodontics and restorative dentistry.

This talk will aim to provide an overview of the relationship between the multi-disciplinary team and discuss the technique of transplantation, where teeth are lost as a result of trauma. Pre-transplant and post-transplant orthodontics will be discussed as well as the restorative rehabilitation of transplanted teeth. The versatility of autotransplantation and its numerous indications will be described involving both open and closed apices.

Hani will discuss the paedodontic aspect of treatment and Nadine will concentrate on the orthodontic and restorative components.

Nadine started her dental career as a trainee Dental Surgery Assistant at the Birmingham Dental Hospital in 1989. She then had a change of plan and qualified as a dentist from the University of Liverpool in 1998. She did her GPT and maxillo-facial SHO posts in Liverpool over 4 years before becoming commencing her orthodontic specialist training in Leeds. She passed her MOrth/MDentSci in 2005 and won the prestigious MOrth cases prize for her treated cases. She completed her FTTA post in Birmingham and Burton upon Trent and passed her ISFE examination in 2007. Nadine has been a consultant orthodontist in Bradford/Leeds/Airedale since 2007 and her areas of interest are autotransplantation, orthognathic surgery and complex orthodontic-restorative cases.

She has an honorary senior lecturer post at The University of Leeds (UoL) and is an examiner for the Royal College of Surgeons of England. She has supervised nine research projects at UoL and has published 16 articles in the scientific literature. She is also the Northern sub-editor for the British Orthodontic Society Clinical Effectiveness Bulletin.

Tooth Transplantation at any age

authors: Dr. Dick Barendregt, Dr. Manfred Leunisse, Dr. Marcel Linssen

Since the first transplantations in the fifties of the last century, the advantages of the use of the patients own material were immediately clear. The disadvantage was that for a successful transplantation the root development of the donor teeth should be 2/3 to 3/4 of the fully developed length. In the literature transplantation of fully developed teeth has been described but the succesrate was not comparable to the transplantations with an open apex. Risk factors such as peri-apical inflammation and ankyloses were commonly described.

Since 2005 transplantation of fully developed teeth has been a routine procedure in Rotterdam with succes rates comparable to transplantation of teeth with open apices after 10 years. In this lecture a detailed description of this procedure will be presented. Topics which will be covered are indications for transplantation of fully developed teeth, timing for the endodontic treatment, moment of functional loading with orthodontic appliances and planning of the prothetic follow-up remodeling the transplanted tooth to the applicable location.

Manfred Leunisse finished his dental school in 1987 at the University of Amsterdam. For one and a half year head did research at the department of orthodontics at het Free University of Amsterdam. In 1989 he started his post-graduated training at the Academic Centre for Dentistry in Amsterdam where he finished his training in January 1993. In march 1993 he founded his own orthodontic practice in Rotterdam. Besides his practice he is giving postgraduate courses for dentists.

Since 1997 the interest has shifted to patients treated in a interdisciplinary team (Proclin) together with Dick Barendregt and with prosthodontists, periodontologists, endodontologist and oral surgeons.
He also lectures in both national and international meetings.

Tooth Transplantation at any age

authors: Dr. Dick Barendregt, Dr. Manfred Leunisse, Dr. Marcel Linssen

Since the first transplantations in the fifties of the last century, the advantages of the use of the patients own material were immediately clear. The disadvantage was that for a successful transplantation the root development of the donor teeth should be 2/3 to 3/4 of the fully developed length. In the literature transplantation of fully developed teeth has been described but the succesrate was not comparable to the transplantations with an open apex. Risk factors such as peri-apical inflammation and ankyloses were commonly described.

Since 2005 transplantation of fully developed teeth has been a routine procedure in Rotterdam with succes rates comparable to transplantation of teeth with open apices after 10 years. In this lecture a detailed description of this procedure will be presented. Topics which will be covered are indications for transplantation of fully developed teeth, timing for the endodontic treatment, moment of functional loading with orthodontic appliances and planning of the prothetic follow-up remodeling the transplanted tooth to the applicable location.

Marcel Linssen got his doctoral degree in dentistry at Utrecht University in 1988 and finished his Dental examinations at the Catholic University of Nijmegen in 1989. From 1991 onwards he was one of the founding fathers of a large general dental clinic in Rotterdam. From 2012 onwards he is working at PRO-Rotterdam, a reference clinic for prosthodontics and restorative dentistry, and PROCLIN, a clinic for the interdisciplinary treatment of dento-alveolar trauma, amelogenesis imperfecta, oligodontia, treatment of wear in combination with orthodontics and autotransplants.

Emphasising the role of Orthodontics and the Versatility of Biological Auto transplantation

authors: Dr. Nadine Houghton, Dr. Hani Nazzal

The Leeds/Bradford autotransplantation team have developed a multidisciplinary approach for the management of anterior teeth with poor prognosis as a result of dental trauma. This involves bone management at the affected site followed by autotransplantation. Since the inception of this programme, we have placed over 180 transplants using the multidisciplinary team comprising of paediatric dentistry, orthodontics and restorative dentistry.

This talk will aim to provide an overview of the relationship between the multi-disciplinary team and discuss the technique of transplantation, where teeth are lost as a result of trauma. Pre-transplant and post-transplant orthodontics will be discussed as well as the restorative rehabilitation of transplanted teeth. The versatility of autotransplantation and its numerous indications will be described involving both open and closed apices.

Hani will discuss the paedodontic aspect of treatment and Nadine will concentrate on the orthodontic and restorative components.

Clinical Lecturer and specialty registrar, paediatric department, school of dentistry, University of Leeds.

Dr. Hani completed three years clinical training in Paediatric Dentistry at the University of Leeds in 2008 after which he obtained a Fellowship in Paediatric Dentistry from the Royal College of Dentists in Canada in the same year. He then worked as a Senior Dental Officer in Paediatric Dentistry at Bradford and Airedale Salaried Dental Services between 2008 and 2012. He recently became a member at the royal college of surgeons in England in paediatric dentistry. He is currently doing his consultant training in Paediatric Dentistry at the University of Leeds, School of Dentistry.

Academically, he obtained a PhD in paediatric Dentistry from the University of Leeds, School of Dentistry in 2008. In 2012, he was appointed as a NIHR Clinical Lecturer in paediatric dentistry where he is the lead for the 4th year module.

His research interests are in the field of premolar transplantation, fluoride anticariogenic effect; slow releasing fluoride device, dental plaque, regenerative endodontics and the use of laser Doppler flowmetry. Hani has multiple publications and coauthored book chapters in addition to presenting in several UK national and international conferences.

Trans-alveolar transplantation of impacted teeth – indications and outcomes.
Bone preservation and regeneration in relation to tooth transplantation.

The lecture will provide information about planning and performing autotransplantation of impacted developing teeth (especially second premolars and lower canines). The description of the surgical technique and factors, which may influence the treatment outcome will be given and discussed.

The alveolar bone preservation and regeneration is an extremely important and promising aspect of autotransplantation of developing teeth. It will be demonstrated, using clinical examples, that those teeth may in some cases serve as a natural providers of bone growth and may help in regeneration of the alveolus in patients with bone defects.

Dr Plakwicz graduated from the Dental Faculty, Academy of Medicine in Warsaw. Between 1995-2003 he was an assistant lecturer at the Department of Oral Surgery at the same university. He completed his postgraduate training in autotransplantation of teeth at the University of Oslo, Norway in 2000. In 2001, he qualified as a specialist in Oral Surgery. Since 2009 he has worked at the Department of Periodontology, Medical University of Warsaw. In 2009 he defended his thesis on autotransplantation of teeth and in 2015 he gained his PhD with habilitation for series of publication under the title: “Periodontal assessment of the treatment outcomes of autotransplantation of developing teeth in growing patients”. He maintaines the private practice focused on oral and periodontal surgery.

His main research interests are in the treatment of growing patients with missing teeth or with eruption disturbances, teeth autotransplantation and mucogingival surgery. He conducts research on the bone growth which follows the transplantation of the teeth to atrophied alveolar ridge He has performed and followed-up more than 230 of autotransplantated teeth. Dr Plakwicz lectures and conducts courses nationally and internationally in Europe and in the United States.

1. Prognostic factors in clinical autotransplantation of teeth. A review over 30 years with special reference to life-table analysis.

Success in transplantation of any tissue is based on prognostic factors of the primary criterion: survival of the graft. During the last 30 years, numerous clinical series of autotransplantation of teeth have been published, dealing with different prognostic factors on long-term survival of tooth graft.

Recent meta-analysis (Almpani et al 2015) of 3,000 transplantations in 36 prospective studies (excluding 800 studies including all retrospective studies, no randomized stydies present) revealed only one significant prognostic factor: root development of the graft.

Life-table stastistics, originally developed in the ensurance business, is used in evaluation of organ transplantation to reveal prognosis of grafts. The present survey of 11 prospective and retrospective studies of 6 controlled data materials, include 1,100 tooth transplantations with a follow-up of 3 to 45 years. The data material, include studies of more than 30 transplantations and follow-up periods of more than 3 years. Using different modalities of lifetable statistics, many of these studies reveal a series of relevant prognostic factors of various significance on the survival. With the limitations such comparison of different data materials demands, some of the prognostic factors with potentially significant impact on survival are evaluated: – apart from root development of the graft – tooth type, endodontic treatment, splinting, antibiotics, experience of the surgeon, private practice vs. university clinics, postoperative orthodontic treatment, and other factors of relevance to the long term survival of transplanted teeth.

2. Cryopreservation of teeth for autotransplantation. Clinical success 28 years after cryopreservation and transplantation.

Cryopreservation is an advanced method used in certain cases of autotransplantation where the graft is stored alive in a tooth bank for several days/months/years of delay, after removal of the donor tooth until the time of transplantation. Cryopreservation of teeth for transplantation is only relevant in seldom and selected cases such as some cleft patients, and some patients with the need for a time period between extraction of donor tooth and orthodontic creation of space the recipient region. Long-term clinical follow-up, with up to 28 years of survival of the graft, including pulpal- and periodontal healing after cryopreservation for years before transplantation, will be presented.

Ole Schwartz, DDS, Ph.D. Oral- and Maxillofacial Surgeon, Consultant.
Department of Oral and Maxillofacial-Surgery, University Hospital, Copenhagen, Denmark

Education

• 1972 Certificate in Dentistry, Royal Dental College, Copenhagen, Denmark
• 1979 Ph.D Thesis: Immunological and Clinical Aspects of Allotransplantation of Teeth in Humans
• 1983 Certificate in Oral & Maxillofacial Surgery, Copenhagen University, Denmark

Appointments

• 1975 Research associate, Department of Oral Surgery, University of Copenhagen, Denmark
• 1980 Research associate, University of Los Angeles, California, USA
• 1981 Senior research associate, University of Copenhagen, Denmark
• 1984 Associate professor in Oral and maxillofacial surgery at University of Copenhagen
• 1993 Head of department, Department of Oral & Maxillofacial Surgery,
  Copenhagen Community Hospitals HS, University Hospitals of Copenhagen.
• 2000 Head of department, Department of Oral & Maxillofacial Surgery, University Hospital,
  Rigshospitalet, Copenhagen
• 2011 Senior consultant, Department of Oral & Maxillofacial Surgery, University Hospital,
  Rigshospitalet, Copenhagen
• 2011 Private practice part time, oral- and maxillofacial surgery, Lyngby

Awards

• 1984 René Le Fort Award, Collegio Brazileiro Cirurgia e Traumatologica Bucco-Maxillo-Facial, Bauru, Brazil
• 1991 SIDO World Award, Italy

Publications

72 scientific articles in peer-reviewed journals, with special focus on topics of transplantation of teeth
Chapters in textbooks:
“Atlas of replantation and transplantation of teeth”,
“Textbook and colour atlas og tooth impactions, diagnosis, treatment and prevention”,
“Textbook and colour atlas of traumatic injuries of the teeth”.

Main research focus

Tooth Autotransplantation, experimental and clinical research including cryopreservation.
Allotransplantation of Teeth, experimental and clinical research including tissue typing, immunological monitoring and and donor-specific immunosuppression.
Maxillofacial rehabilitation including bone grafting and anvanced implantology

Autotransplatation of teeth with complete root formation – from indication to prognosis

Many clinical studies regarding autotransplantation with immature teeth have been reported since the 1950s. A large number of clinical studies on immature tooth transplantation have evaluated root development, pulpal healing, and root resorption after autotransplantation. In contrast, autotransplantation with complete root formation has been reported often since 1980. Autotransplantation of teeth with complete root formation is indicated for the replacement of one or more teeth that were lost because of dental caries or periodontitis in adult patients. However, autotransplantation of teeth with complete root formation sometimes fails; therefore, the main factors affecting prognosis of tooth autotransplantation in adult patients should be investigated. Since 1994, we have performed more than 50 autotransplantations of teeth with complete root formation annually at Niigata University Medical and Dental Hospital, Japan, and have evaluated their prognosis and prognostic factors. In this lecture, the details of autotransplantations of teeth with complete root formation in our hospital, Japan and the results of our studies will be presented.

Education

• 1990 DDS, Dentistry, Niigata University, Japan
• 1994 PhD, Oral & Maxillofacial Surgery, Niigata University, Japan

Professional Training and Employment

• 1995-1997 Dentistry Resident, Oral & Maxillofacial Surgery, Niigata University, Hospital of Dentistry, Niigata, Japan
• 1998-2002 Assistant Professor, Department of Oral & Maxillofacial Surgery, Niigata University
• 1999-2000 Research Fellow, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
• 2003 – Assistant Professor, Division of Reconstructive Surgery for Oral and　Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
• 2011 – Lecture, Department of Oral Reconstructive Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan
• 2016 – Professor, Department of Oral and Maxillofacial Surgery, Matsumoto Dental University School of Dentistry

Membership

• Japanese Society of Oral and Maxillofacial surgeons
• International Association of Oral and Maxillofacial surgeons
• Asian Association of Oral and Maxillofacial surgeons
• The Japanese Society for Regenerative Medicine

Qualification

Specialist authorized by Japanese Society of Oral and Maxillofacial surgeons
General Clinical Oncologist by Japanese Board of Cancer Therapy (Oral Surgery)
Specialist in regenerative medicine authorized by The Japanese Society for Regenerative Medicine

Specialization

Oral surgery, Tooth transplantation, Regenerative medicine of oral and maxillofacial region, Oral cancer