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UNC's Adams School of Dentistry pioneers a procedure worth smiling about

dentistry-autotransplantation

“Tooth autotransplantation is taking a tooth from a place where you may not need it and moving it to another place where it could be better used,” said Jessica Lee, professor and chairperson of the pediatric dentistry department at the School of Dentistry.   Photo Courtesy of Sonny Long. Video by Ben Premeaux. 

The UNC Adams School of Dentistry hopes to create even more smiles on children's faces by turning so-called 'throwaway teeth,' like wisdom teeth, into useful contributions for an amazing smile – UNC dentists are the first to perform an autotransplantation in the United States

“Tooth autotransplantation is taking a tooth from a place where you may not need it and moving it to another place where it could be better used,” said Jessica Lee, professor and chairperson of the pediatric dentistry department at the School of Dentistry.  

When a child loses a tooth through trauma it is devastating, not only to their physical appearance but also psychologically, Lee said in a video about the process.  

Implants, which involve putting a fake tooth in place of a missing one, can lead to more problems, such as inflammation, because implants can't move but teeth can. Oral implant surgeries have become commonplace, but UNC dentists learned about autotransplantation through Paweł Plakwicz, a Polish oral surgeon.

In Europe, autotransplantation has been practiced for many years and has a 90 percent success rate, said Sonny Long, a pediatric dentist and orthodontist. It is also widely practiced in Canada and has long-term success. UNC is the first in the United States to practice autotransplantation. 

Long, who works with Lee, said he read an article about a girl who had fallen off of a horse and lost her two front teeth. The doctors that treated her transplanted one tooth from the lower part of her mouth and then put it in the place of one of the front teeth and closed the gap. He was so impressed by the procedure that he asked if he could use it for class.

Plakwicz and colleague Ewa Czochrowska first came to UNC to teach a day-long Continued Education course about the procedure and how it works.

Two cases came to UNC – two young girls who needed oral surgery. Long sent the records of the first girl to Czochrowska and Plakwicz in Poland and asked if she was a good candidate for autotransplantation, and they said absolutely. 

“We have a video of that day where he (Plakwicz) flew over and guided one of our surgeons through that procedure, and it was pretty remarkable,” Lee said. 

Nine months after her autotransplantation procedure, the patient is doing well, and Lee hopes this procedure will benefit even more children in the future. She imagines UNC becoming a hub for dental autotransplantation in the U.S. 

UNC Health Care has a pediatric trauma team, headed by Dr. Beau Meyer, which includes pediatric surgical specialists in oral surgery. The team gets referrals from outside practitioners and provides consultations. Pediatric dental trauma does not happen often, but UNC now has a team with endodontist, periodontist, prosthodontist, orthodontist and pediatric dentist to figure out how to reconstruct a smile for a child. 

“Everyone – from the faculty to the staff to the classmates – they're the total Carolina student you would imagine," said Shadoe Stewart, a dental surgery student, of the people at the School of Dentistry. "They're just down to earth, they’re truly passionate about what they do, they're pushing the needle forward on projects, they're coming up with all these different things to help other people, not just to build resumes."

@NathanKWesley

university@dailytarheel.com

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