Third Molar Autotransplantation With Rct: A Functional Case Report

Third molar autotransplantation offers a biological solution for replacing non-restorable molars, combining functional rehabilitation with alveolar preservation. This case demonstrates the efficacy of root canal therapy (RCT) in optimizing outcomes, supported by systematic review data (96% 1-year survival post-RCT). A 28-year-old female underwent autotransplantation of impacted third molars (#38, #48) to replace missing #46 and #47. Preoperative CBCT confirmed donor root maturity and recipient bone compatibility. Minimally invasive extraction/transplantation was followed by delayed RCT (4 weeks) using WaveOne File (reciprocating system, Dentsply Sirona) and iRoot SP® (calcium silicate sealer, Innovative BioCeramix Inc.). At 3 months, stable occlusion, restored function, and radiographic periodontal regeneration were observed. Key decisions: 1) RCT significantly reduced pulp necrosis risk (systematic review data: 96% survival with RCT vs. 58% without RCT) and prevented inflammatory resorption.; 2) WaveOne File reduced procedural risks in curved canals; 3) Bioceramics enhanced apical sealing. This approach achieved implant-comparable function while preserving proprioception and bone dynamics—advantages absent in prosthetics. Third molar autotransplantation with modern endodontics provides a viable, biology-driven alternative to implants. The protocol’s 3-month success supports its integration into tooth replacement strategies, particularly for young patients requiring long-term alveolar preservation.