A long-term study of 370 autotransplanted premolars. Part I. Surgical procedures and standardized techniques for monitoring healing.

Tooth autotransplantation has recently become a method of treating certain orthodontic problems. Over a 13-year period 370 premolar transplants were monitored by electrometric pulp sensibility testing and radiographic examination for pulp and periodontal ligament healing as well as root growth. This article describes the surgical technique as well as the precision of sensibility testing and radiographic examination for evaluating transplant healing. The sensibility response was found markedly related to the stage of tooth development but not to the type of premolar. The precision of sensibility testing (i.e. deviation of two consecutive measurements at a few weeks' interval) was found to range from 15-36 per cent for the different stages. Film holders were used to standardize the intraoral radiographic exposures. The precision percentage for the measuring technique of tooth length and crown width based on a single radiograph read twice (reading error) ranged from 1.1 to 1.8 with only small variations among the different types of premolar. The precision percentage of the radiographic exposure technique evaluated from two consecutive radiographs (measuring plus exposure error) was found to range from 1.2 to 4.2, again with small variations among the different premolars. The accuracy of the radiographic technique (i.e. deviation of radiographically determined tooth dimensions from the true values) was found to range from 2.0 to 2.9 with only small variation between the various types of premolar. In conclusion the evaluation of electrometric sensibility testing should take into account the stage of root formation of premolars.