Case Report/Clinical Techniques

Autotransplantation of Immature Third Molars Using

a Computer-aided Rapid Prototyping Model:
A Report of 4 Cases
Ji-Hyun Jang, DDS, MSD, Seung-Jong Lee, DDS, MSD, PhD, and Euiseong Kim, DDS, MSD, PhD

Abstract
Introduction: Autotransplantation of immature teeth
can be an option for premature tooth loss in young
patients as an alternative to immediately replacing teeth
W hen the contemporary clinician confronts missing teeth or severely compromised
teeth, the treatment options are the placement of a dental implant or restoration
with a fixed prosthesis. However, the management of missing teeth in young patients is
with fixed or implant-supported prostheses. The present always a challenge for dentists. Thus, autotransplantation has been suggested as an
case series reports 4 successful autotransplantation alternative option to rehabilitate prematurely lost teeth (1–3). Autotransplantation
cases using computer-aided rapid prototyping (CARP) was first reported in the 1950s when immature third molars were used to replace
models with immature third molars. Methods: The decayed first molars (4). Subsequently, there have been a number of clinical studies
compromised upper and lower molars (n = 4) of on autotransplantation using immature permanent third molars. Recent studies have
patients aged 15–21 years old were transplanted with reported promising success rates ranging from 74%–100% by appropriately selecting
third molars using CARP models. Postoperatively, the patients and using careful surgical techniques (2, 3, 5, 6).
pulp vitality and the development of the roots were Postoperative root development and pulp revascularization are not to be expected
examined clinically and radiographically. The patient after transplantation with mature teeth. The pulp of a completely developed tooth is diffi-
follow-up period was 2–7.5 years after surgery. Results: cult to regenerate. Therefore, if the tooth is scheduled to be transplanted, endodontic
The long-term follow-up showed that all of the trans- treatment should be completed before transplantation. Otherwise, the endodontic treat-
plants were asymptomatic and functional. Radiographic ment should be initiated 1–2 weeks after transplantation to prevent inflammatory root
examination indicated that the apices developed contin- resorption that may develop from the necrotic pulp (7, 8). However, a tooth with an
uously and the root length and thickness increased. The open apex has a greater potential for pulp revascularization after replantation (7, 9).
final follow-up examination revealed that all of the Because immature third molars often contain a rich blood supply and stem cells,
transplants kept the vitality, and the apices were fully postoperative root development is dependent on the preserved activity of the Hertwig
developed with normal periodontal ligaments and epithelial root sheath (HERS). The presence of an abundant HERS not only results in
trabecular bony patterns. Conclusions: Based on root development but also affects periodontal healing (10).
long-term follow-up observations, our 4 cases of auto- The key factors affecting preservation of the HERS are extraoral time of the trans-
transplantation of immature teeth using CARP models plant and surgical trauma, which are closely correlated with each other (11, 12).
resulted in favorable prognoses. The CARP model assis- Surgical trauma caused while contouring the recipient bone bed to place the donor
ted in minimizing the extraoral time and the possible tooth can result in only limited extraoral time and preserve the HERS cells of the
Hertwig epithelial root sheath injury of the transplanted root surface. Lee et al (13) suggested using the computer-aided rapid prototyping
tooth. (J Endod 2013;39:1461–1466) (CARP) donor tooth and jaw model in autotransplantation. A CARP model is fabricated
using 3-dimensional image information from cone-beam computed tomographic
Key Words (CBCT) imaging. This technique permits analysis of the actual dimensions of the donor
Autotransplantation, computer-aided rapid prototyping tooth and extraction socket before beginning the surgical procedure. Moreover, the
model, continued root development, extraoral time, recipient bone cavity can be prepared using a CARP tooth model before extraction
Hertwig epithelial root sheath, immature third molar during surgery in an attempt to reduce the extraoral time and the possible HERS injury
of the transplanted tooth (12, 13).
The purposes of this case series were to report 4 successful transplantation cases
using CARP models with immature third molars, which showed significant continued
root development. We also analyzed the factors affecting the predictability of the
procedures.

From the Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
Supported by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD) (KRF-2007-313-E00508).
Address requests for reprints to Dr Euiseong Kim, Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry,
Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. E-mail address: andyendo@yuhs.ac
0099-2399/$ - see front matter
Copyright ª 2013 American Association of Endodontists.
http://dx.doi.org/10.1016/j.joen.2013.06.026

JOE — Volume 39, Number 11, November 2013 Autotransplantation of Immature Third Molars 1461
Case Report/Clinical Techniques
Case Reports with 4-0 Vicryl (Ethicon, Somerville, NJ) without splints, and the
Case 1 occlusal interferences were adjusted (Fig. 1B).
The patient returned yearly for clinical and radiographic follow-
A 15-year-old female patient was referred to the Department of
up. At the follow-up visits, the transplant was asymptomatic and func-
Conservative Dentistry at Yonsei University Dental Hospital for an eval-
tional. The tooth responded positively to the cold test, and periodontal
uation of the left mandibular second molar. The patient’s dental history
probing was within the normal limits at all follow-up visits. On radio-
revealed that root canal therapy on tooth #18 was incompletely per-
graphic examinations, the apex was shown to have developed continu-
formed several years ago. A clinical examination showed the extensive
ously with increasing length and thickness of the root at every annual
caries around the furcation of #18, and the tooth was tender to percus-
examination (Fig. 1C, D, and E). At the last 7-year follow-up visit, the
sion, palpation, and biting. A periapical radiograph of #18 showed
apex was fully developed, and a trabecular bony pattern was observed
increased periapical radiolucency and widened periodontal ligament
around tooth #17.
space (Fig. 1A). As a result, #18 was diagnosed as having symptomatic
apical periodontitis, and an extraction was planned. The vertically erup-
ted tooth #17 had undergone one half of root development and was Case 2
scheduled for transplantation into the extraction socket. A CBCT image A 16-year-old female patient was referred for transplantation of an
(Volux System; Genoray, Seongnam, Korea) was taken to analyze the impacted mandibular third molar. The patient’s dental history indicated
volumetric size of the donor tooth and recipient bone. Three- that impacted tooth #17 was intended to be extracted before ortho-
dimensional digital data of the donor tooth was obtained and converted dontic treatment. Additionally, tooth #18 was undergoing eruption
into a Digital Imaging and Communications in Medicine format file. The with infraocclusion. Tooth #18 was confused with the impacted #17,
Digital Imaging and Communications in Medicine file was analyzed in and #18 was removed iatrogenically. The #17 tooth had undergone
a visualization program (V-works; Cybermed Co, Seoul, Korea) and partial root development and was scheduled for transplantation into
then exported to the rapid prototyping machine for the fabrication of an edentulous area after a weeklong delay (Fig. 2A).
the actual sized tooth starch model. The adaptability of the donor tooth Under local anesthesia, mucoperiosteal flaps were raised, and an
to the recipient site was examined on a jaw model that was fabricated osteotomy was created to approach tooth #17, which was horizontally
using a CARP process before surgery. impacted. The recipient site was reshaped using the CARP model.
Mucoperiosteal flaps were raised in the area of teeth #18 and #17 Immature tooth #17 was extracted and transplanted immediately to
under local anesthesia. Tooth #18 was extracted first, and the recipient the recipient socket. The transplant was stabilized with a resin/wire
site was prepared by removing the crestal bone with a Lindemann drill splint, and the occlusal interferences were adjusted (Fig. 2B).
(Komet, Lemgo, Germany) or a round burr (Centerpunch Bur; De- At the follow-up visits, there were no clinical or radiographic signs
gussa, Dusseldorf, Germany) with copious saline irrigation to produce of failure of autotransplantation. The transplant was asymptomatic and
the proper size and shape of the socket to receive the donor tooth. The functional. At the last 2.9-year follow-up, the root was developed, and
prepared socket was adjusted using the CARP model. The donor tooth the pulpal space was partially obstructed (Fig. 2C and D).
#17 was extracted carefully to ensure the radicular periodontal tissues
remained intact. The tooth was transplanted to the recipient site without Case 3
extraoral storage. The donor tooth was held in position with firm pres- A 19-year-old male patient was referred to the Department of
sure for 3 minutes. The transplant was stabilized with crossover sutures Conservative Dentistry for an evaluation of the left and right mandibular

Figure 1. (A) The preoperative panoramic radiograph. Tooth #18 (arrow) showed extensive caries around the furcation area. Partially erupted immature tooth
#17 (star) was planned to be transplanted. (B) The postoperative periapical radiograph. (C) Two years after autotransplantation. The transplant showed continued
root development without any inflammation or resorption. The marginal bone support revealed a similar level compared with the adjacent teeth. (D and E) Intraoral
photographs after 2 years. The transplant was asymptomatic and functional.

1462 Jang et al. JOE — Volume 39, Number 11, November 2013
 Case Report/Clinical Techniques

Figure 2. (A) Preoperative panoramic radiograph. Tooth #18 (arrow) was confused with tooth #17 (star); #17 was intended to be extracted before orthodontic
treatment, but #18 was removed iatrogenically. (B) Postoperative periapical radiograph. Horizontally impacted immature tooth #17 was autotransplanted into the
#18 site. (C) Two years 9 months later. (D) Postoperative panoramic radiograph at 1 year 6 months. The transplant showed continued root development with
healthy marginal alveolar bone support similar to the adjacent teeth.

second molars. The clinical and radiographic examinations showed Under local anesthesia, a small area of the mucoperiosteal flap
extensive caries of #18 and #31 with increased periapical radiolucency in the right mandibular area corresponding to the diameter of the
and widened periodontal ligament space (Fig. 3A). Both tooth #18 and potential transplant was excised. Next, a new socket cavity was
#31 were diagnosed as symptomatic apical periodontitis, and extrac- created in the alveolar bone with a low-speed Lindemann drill under
tions were planned. Additionally, impacted immature third molars copious saline irrigation. The cavity was finally prepared and
#17 and #32 were observed on a panoramic radiograph and scheduled adjusted using a CARP model. Then, impacted donor tooth #01
for transplantation into the extracted socket. CBCT imaging was ob- was surgically extracted and was transplanted into the recipient
tained to analyze the volumetric measurements of the donor teeth socket. Graft material (Bio-Oss; Geistlich Sons Ltd, Wolhusen,
and to fabricate the CARP models. Switzerland) was packed on the buccal bony dehiscence area and
The surgical procedure was similar to that described for case 1 an absorbable collagen membrane (Bio-Gide; Geistlich Pharma
(Fig. 3B and C). The #17 and #32 teeth had complete root development, AG, Wolhusen, Switzerland) was placed on the graft to avoid migra-
but the amount of apex closure was different. Tooth #17 had more than tion of the graft and the invasion of soft tissues. The transplant was
1 mm of closure, whereas tooth #32 had slightly less than 1 mm. Ac- stabilized by crossover sutures (Fig. 4B).
cording to conventional guidelines (14), root canal treatment was per- After surgery, the patient reported sensitivity to percussion initially,
formed only on #32 2 weeks postoperatively. At every follow-up visit, the but after 3 months of follow-up, the transplant was functional without
transplants were asymptomatic and functional. Tooth #17 responded any discomfort. The apex developed continuously, with increasing
positively to the cold test. At the last 2-year follow-up visit, the apex length and thickness of the root at every annual visit. The 7-year post-
was closed continuously, and the pulp space was becoming opaque operative radiograph showed complete development of the root with
on radiographic examinations, which showed pulp vitality. The periap- a periodontal ligament and trabecular bony pattern around the trans-
ical radiographs that were taken at the 2-year follow-up showed plant (Fig. 4C and D). The clinical and radiographic findings of the 4
increased radiopacity around the transplants compared with the post- cases are summarized in Table 1.
operative periapical radiographs (Fig. 3D and E).
Discussion
Case 4 Tooth autotransplantation is not as popular as expected despite
A 21-year-old female patient was referred from the Department of many reports of high success rates (2, 5, 12). The reasons for
Orthodontics at the Yonsei University Dental Hospital for transplantation hesitation in choosing this treatment option might be the complexity
of tooth #01 into an edentulous right first mandibular site. The patient’s of the procedure, technique sensitivity, and unpredictable prognosis
dental history indicated that tooth #30 had been extracted because of based on varying clinical environments (9). In particular, the control
extensive dental caries and pain 3 years ago. The patient had received of extraoral time has been the main concern related to the vitality of
orthodontic treatment after extraction, and the edentulous space of #30 periodontal cells and dry storage of more than 30 minutes usually
was maintained. Donor tooth #01 was fully impacted and showed causes irreversible cell damage (15, 16). Multiple inserting trials to
approximately two thirds of root development was complete. A trans- fit transplants into the recipient bed not only extend the extraoral
plantation of #01 was planned into the surgically created sockets in time but can also result in the failure of periodontal healing of the
the right first mandibular site (Fig. 4A). donor tooth. However, the CARP technique provides a solution to the

JOE — Volume 39, Number 11, November 2013 Autotransplantation of Immature Third Molars 1463
Case Report/Clinical Techniques

Figure 3. (A) The preoperative panoramic radiograph; #18 and #31 (arrow) showed extensive caries around the furcation area. Impacted immature teeth #17
and #32 (star) were planned to be transplanted. (B and C) Postoperative periapical radiographs. The stages of root development were stage 4 and 5, respectively.
(D and E) Two years after autotransplantation. A root canal treatment was performed on #32 because the size of the apex was less than 1 mm at baseline #17, which
had an open apex of more than 1 mm, and showed continued apex closure and narrowing of the pulpal space. Both transplants were functional without any
symptoms.

1464 Jang et al. JOE — Volume 39, Number 11, November 2013
 Case Report/Clinical Techniques

Figure 4. (A) The preoperative panoramic radiograph. Impacted tooth #01 (star) was planned to be autotransplanted into the edentulous right first mandibular
site. (B) The postoperative periapical radiograph. (C and D) Panoramic and periapical radiograph at 6 years after autotransplantation. The transplant showed
continued root development. Notice the induced marginal alveolar bone after transplantation.

problem of extraoral time. CBCT imaging has found its place in the 2 to 4 as suggested by Andreasen et al (14).The publication re-
clinical armamentarium over the last 10 years. The use of CBCT ported a long-term study of 370 autotransplanted teeth and sug-
imaging provided a better diagnostic device for analyzing the gested decisive factors for pulp regeneration. The factors
anatomical structure before surgery and for fabricating CARP models affecting revascularization appeared to be the root developmental
(17). The use of CARP models before extracting real transplants allows stage, and pulpal healing was dependent on the diameter of the
clinicians to better manage extraoral time. Moreover, unnecessary apical foramen. The study concluded that immature teeth from
damage to the periodontal ligaments caused by checking for the fit in late stage 2 (one-half length of root formation) to stage 4
the prepared socket can be avoided using the CARP model. The discrep- (three-quarters to less than four-quarters length of root formation)
ancies between human permanent teeth and CARP models were re- were recommended for autotransplantation. Teeth beyond stage 5
ported to be only 0.291 mm (13). The study was performed only (complete root formation with half-apical constriction) are not rec-
with permanent mature human teeth. However, based on our cases, ommended because of their frequent incidence of pulp necrosis.
the CARP model is also useful for impacted immature third molars. This conclusion has been supported by other studies (8, 14, 18–
In our cases, all of the transplants were immature teeth and using the 20). The transplants in cases 1 and 2, which were in late stage
CARP model contributed to minimizing the extraoral time. As a result, 2, showed significant increases in root length and root wall
all of the cases showed a normal probing depth at the final follow-up thickness. The transplanted teeth in the latter cases, 3 and 4,
visits, and there was no ankylosis or root resorption at the final were in stage 4 and 3, respectively. These cases also showed
follow-up examinations. increases in root length, but they were not as prominent as in
The present 4 transplants in our study showed continuity of the former cases. In the present 4 cases, the impacted
root development. All of the cases were in the stage varied from transplants were covered with thick follicles and periodontal

TABLE 1. Summary of Clinical and Radiographic Findings

Immediate Root Use of Positive Increase
Case Recipient Donor Age (y)/ or delayed development Extraoral CARP Follow-up to cold in root
no. tooth tooth sex approach stage time model period test length (%)
1 18 17 15.4/F Immediate 2 Immediate O 7Y 3M + 39.89
2 18 17 16.1/F Delayed 2 Immediate O 2Y 9M + 67.76
3 18 17 19.5/M Immediate 4 Immediate O 2Y + 6.30
31 32 Immediate 5 Immediate O - RCT
4 30 01 21.8/F Delayed 3 2 min 23 sec O 7Y 6M + 15.34
The stage of root development was estimated clinically during transplantation surgery and radiographically on the postoperative radiograph according to the classification of Moorrees (18). The root length was
measured with a periapical radiograph as a vertical line from the cementoenamel junction to the apex of the tooth using the image calibration software program PiViewSTAR (INFINITT, Seoul, Korea).

JOE — Volume 39, Number 11, November 2013 Autotransplantation of Immature Third Molars 1465
Case Report/Clinical Techniques
ligaments, and they were extracted with light continuous force. As Acknowledgments
a result of favorable clinical conditions, the HERS of the root
cemental surfaces were not injured and were preserved around The authors deny any conflicts of interest related to this study.
the apices (21). It is known that the HERS can organize the apical
cells and provide nutrition by diffusion from the recipient site until References
revascularization under favorable conditions (15, 20) and can lead 1. Trope M. Clinical management of the avulsed tooth: present strategies and future
to continued root formation (22). directions. Dent Traumatol 2002;18:1–11.
Many studies have reported pulp regeneration in autotransplanta- 2. Keightley AJ, Cross DL, McKerlie RA, et al. Autotransplantation of an immature
tion with immature teeth (9, 12, 13, 23–25). If the necrotic pulp premolar, with the aid of cone beam CT and computer-aided prototyping: a case
report. Dent Traumatol 2010;26:195–9.
remains uninfected, blood capillaries can invade the pulp canal
3. Singh KK, Dudani IC. Autogenous transplantation of developing mandibular third
through the wide apical foramen and supply nutrition to invading molars. J Indian Dent Assoc 1970;42:199–212.
replacement cells. If the HERS is preserved, it will differentiate into 4. Apfel H. Autoplasty of enucleated prefunctional third molars. J Oral Surg 1950;8:
the pulpal cells that will eventually fill the pulpal canals and cavities 289–96.
(16, 23, 26). Cardona et al (27) reported a long-term follow-up study 5. Lundberg T, Isaksson S. A clinical follow-up study of 278 autotransplanted teeth. Br
J Oral Maxillofac Surg 1996;34:181–5.
showing that autotransplantation with teeth that had incomplete root 6. Czochrowska EM, Stenvik A, Bjercke B, et al. Outcome of tooth transplantation:
development resulted in successful healing of pulp and periodontal survival and success rates 17-41 years posttreatment. Am J Orthod Dentofacial Or-
tissue, and favorable root formation that permitted proper alveolar thop 2002;121:110–9.
bone growth. In our cases, 2–7.5 years after treatment all transplants 7. Wang SH, Chung MP, Su WS, et al. Continued root formation after replantation and
with immature teeth have shown good maintenance of pulp health root canal treatment in an avulsed immature permanent tooth: a case report. Dent
Traumatol 2010;26:182–5.
and regeneration of alveolar bone. 8. Tsukiboshi M. Autotransplantation of teeth: requirements for predictable success.
A recent retrospective study examined tooth autotransplantation Dental traumatology. Dent Traumatol 2002;18:157–80.
with complete root formation and reported an 84% success rate. There 9. Kumar R, Khambete N, Priya E. Successful immediate autotransplantation of tooth
was no inflammation or replacement root resorption during the follow- with incomplete root formation: case report. Oral Surg Oral Med Oral Pathol
Oral Radiol 2013;115:e16–21.
up period (24). Interestingly, in case 3, we encountered 2 different- 10. Hupp JG, Mesaros SV, Aukhil I, et al. Periodontal ligament vitality and histologic
sized apices with similar root lengths (Fig. 3A). The left mandibular healing of teeth stored for extended periods before transplantation. Endod Dent
third molar, which was in stage 4, was transplanted and monitored Traumatol 1998;14:79–83.
continuously, resulting in a closed apex at the final 2-year follow-up 11. Savi A, Turillazzi O, Cocconi R, et al. Central incisor loss after delayed replantation
visit. This outcome revealed that a sufficiently developed tooth could still following avulsion: a contemporary restorative and adjunctive orthodontic manage-
ment approach. Dent Traumatol 2012;28:161–5.
be a viable selection for pulp regeneration if it has an open apex of more 12. Kim E, Jung JY, Cha IH, et al. Evaluation of the prognosis and causes of failure in 182
than 1 mm. The right mandibular third molar showed complete root cases of autogenous tooth transplantation. Oral Surg Oral Med Oral Pathol Oral Ra-
formation with an apex less than 1 mm and was treated endodontically diol Endod 2005;100:112–9.
2 weeks after transplantation. Tooth #32 had a favorable outcome 13. Lee SJ, Jung IY, Lee CY, et al. Clinical application of computer-aided rapid prototyp-
ing for tooth transplantation. Dent Traumatol 2001;17:114–9.
without any complications. Tooth autotransplantation is still a feasible 14. Andreasen JO, Paulsen HU, Yu Z, et al. A long-term study of 370 autotransplanted
option even if the donor tooth has complete root formation in cases premolars. Part II. Tooth survival and pulp healing subsequent to transplantation.
that are selected and treated properly. Eur J Orthod 1990;12:14–24.
Previous investigations have found that delayed revascularization 15. Kristerson L, Andreasen JO. Autotransplantation and replantation of tooth germs in
might influence periodontal healing and root development (28–30). monkeys. Effect of damage to the dental follicle and position of transplant in the
alveolus. Int J Oral Surg 1984;13:324–33.
The transplantation into surgically created sockets results in delayed 16. Skoglund A, Hasselgren G. Tissue changes in immature dog teeth autotransplanted
revascularization and inadequate nutrition. Bauss et al (28) reported to surgically prepared sockets. Oral Surg Oral Med Oral Pathol 1992;74:789–95.
that transplantation into surgically created sockets showed a signifi- 17. Petersson A, Axelsson S, Davidson T, et al. Radiological diagnosis of periapical bone
cantly shorter final root length and root length increments than trans- tissue lesions in endodontics: a systematic review. Int Endod J 2012;45:783–801.
18. Moorrees CF, Fanning EA, Hunt EE Jr. Age variation of formation stages for ten
plantation into fresh extraction sockets. The author explained that the permanent teeth. J Dent Res 1963;42:1490–502.
impaired root development and periodontal healing might have 19. Kim E, Cho SW, Yang JY, et al. Tooth survival and periodontal tissues healing of
occurred because of damage to the HERS. However, the periodontal allogenic-transplanted teeth in the mice. Oral Dis 2006;12:395–401.
healing was not affected by the surgery timing in the present cases. In 20. Skoglund A, Hasselgren G, Tronstad L. Oxidoreductase activity in the pulp of re-
cases 2 and 4, transplantation was delayed by a week and 3 years, planted and autotransplanted teeth in young dogs. Oral Surg Oral Med Oral Pathol
1981;52:205–9.
respectively. Regardless of the time of the surgical approach, transplan- 21. Smith JJ, Wayman BE. Successful autotransplantation. J Endod 1987;13:77–80.
tation improved the root and alveolar development, and it provided 22. Cooke C, Rowbotham TC. The closure of open apices in non-vital immature incisor
proprioceptive stimulation that re-established growth in periodontal teeth. Br Dent J 1988;165:420–1.
healing. The favorable results of the present study, contrary to previous 23. Kvinnsland I, Heyeraas KJ. Cell renewal and ground substance formation in re-
planted cat teeth. Acta Odontol Scand 1990;48:203–15.
investigations, might be attributed to the application of the CARP model 24. Bae JH, Choi YH, Cho BH, et al. Autotransplantation of teeth with complete root
during the transplantation procedure. The use of the CARP model for formation: a case series. J Endod 2010;36:1422–6.
trial insertion during the preparation of the recipient site seems to be 25. Chung H, Kim M, Yang W, Ko H. An interesting healing outcome of a replanted imma-
mandatory to avoid unnecessary manipulation of the transplant and ture permanent tooth: a case report. Dent Traumatol 2011;27:77–80.
HERS damage. 26. Skoglund A. Pulpal survival in replanted and autotransplanted apicoectomized
mature teeth of dogs with prepared nutritional canals. Int J Oral Surg 1983;12:31–8.
Based on long-term follow-up observations, our 4 cases of au- 27. Cardona JL, Caldera MM, Vera J. Autotransplantation of a premolar: a long-term
totransplantation with immature teeth using CARP models resulted follow-up report of a clinical case. J Endod 2012;38:1149–52.
in favorable prognoses. The CARP model was very helpful in 28. Bauss O, Zonios I, Rahman A. Root development of immature third molars trans-
reducing the extraoral time and the possible HERS injury of the planted to surgically created sockets. J Oral Maxillofac Surg 2008;66:1200–11.
29. Swiatkowski W, Rahnama M, Tomaszewski T. Replantation and transplantation
transplanted tooth. In the management of compromised teeth, auto- following avulsion of two maxillary incisors. Dent Traumatol 2007;23:60–3.
transplantation can be a viable option if the cases are selected and 30. Bauss O, Engelke W, Fenske C, et al. Autotransplantation of immature third molars into
treated properly. edentulous and atrophied jaw sections. Int J Oral Maxillofac Surg 2004;33:558–63.

1466 Jang et al. JOE — Volume 39, Number 11, November 2013