(TC04) Autotransplantation for the Esthetic Management of Macrodontia

Macrodontia is a rare dental anomaly, affecting 0.3 – 1.9% of people worldwide. The etiology is thought to be multifactorial, extending from genetic, environmental and endocrine abnormalities. The result is a tooth or teeth that are two standard deviations larger than the average tooth for their gender and age. Although this anomaly usually presents asymptomatically, due to the larger dimensions, it often affects the patient’s esthetics, occlusion and eruption sequence of adjacent teeth. Furthermore, macrodontia has been reported to occur concomitantly with supernumerary teeth, also a rare dental anomaly, affecting 0.1-3.8% of the permanent dentition.

Having multiple dental anomalies is uncommon and often necessitates a more comprehensive and multidisciplinary approach for a successful outcome. The purpose of this table clinic is to present the treatment of a nine-year-old male patient with a macrodontic permanent maxillary central right incisor and a supernumerary permanent maxillary lateral left incisor. As esthetics, function and eruption pattern were the primary concerns, endodontic and orthodontic treatment plans were coordinated to provide the best long-term esthetic and functional results. The macrodontic and the supernumerary teeth were extracted, and the supernumerary tooth was then immediately transplanted into the macrodontic site. When the autotransplanted tooth showed signs of healing into the recipient site, orthodontic treatment was initiated to realign the tooth into the arch.

This table clinic demonstrates a novel approach to treating macrodontia by the autotransplantation of a supernumery tooth into that site to greatly improve the esthetics, function and occlusion of a young patient while preserving the natural dentition and its alveolar process.