Root Canal Treatment Of Tuarodontism-Affected Tooth After Tooth Autotransplantation

Tooth autotransplantation offers an effective solution for addressing tooth defects by transplanting donor teeth into areas of tooth loss. Taurodontism is a rare dental anomaly with unique challenges for root canal procedures due to specific root and pulp chamber abnormalities. This case report details a microscopic root canal treatment following the autotransplantation of a taurodontism-affected maxillary wisdom tooth. A 31-year-old female, 15 days after autotransplantation of her right upper wisdom tooth to the alveolar bone of her lower second molar, exhibited periapical translucency in tooth 18,was referred for root canal treatment. Cone-beam computed tomography (CBCT) identified severe taurodontism with calcified tissue in the pulp chamber and root canals. Treatment included establishing straight-line access with an operating microscope, removing calcifications using ultrasonic instruments, and navigating the canals with C+ files. NiTi instruments and 1% NaClO solution were used for chemo-mechanical preparation. The two-year follow-up showed no symptoms or periapical radiolucency, normal occlusal function, indicating successful root canal treatment post-autotransplantation. The case complexity stems from taurodontism and calcification in the wisdom tooth's pulp chamber and root canals. Tooth rotation during transplantation, with complex root canals (type 1-3) further complicated canal orifice identification. CBCT was used to assess calcifications in root canals. With a dental operating microscope and ultrasonic instruments, root canal orifices were successfully identified, navigated, and prepared for obturation. The use of CBCT and dental microscopy significantly improves treatment outcomes of root canal therapy after tooth autotransplantation.