Transplant vs implant in a patient with agenesis of both maxillary lateral incisors: A 9-year follow-up

• Long-term success after application of a dental implant and a tooth transplant is possible in the anterior maxilla.
• Favorable periodontal status of a transplanted wisdom tooth to replace an upper lateral incisor was documented.
• Natural tooth substitutions are recommended in the anterior maxilla whenever possible.

IntroductionAgenesis of a maxillary lateral incisor occurs in about 2% of the population. Treatment options should adapt to natural biologic changes in a lifelong perspective.Methods and resultsA young woman with bilateral agenesis of the maxillary lateral incisors was treated with transplantation of a developing maxillary third molar on one side and a dental implant on the contralateral side, after orthodontic space opening. The periodontal examination, including bacterial testing of the transplant, the implant, and the control central incisor, was performed 9 years after the treatment. A radiologic assessment was also performed. The transplanted tooth did not differ from a natural incisor, except for the pulp obliteration, and the total bacteria count was higher at the implant site. The periodontal tissues around the implant showed progressive signs of recession.ConclusionsBoth tooth transplants and dental implants for replacing missing maxillary incisors can be effective in the long term. This report supports natural tooth substitution rather than implant placement for dental agenesis in the anterior maxilla.