Evaluation effect of fragile fracture technique and platelet-rich fibrin usage on pulp revascularisation in autotransplantation of mature teeth: A prospective cohort study

Aim: In this study, it was aimed to evaluate the effects of using fragile fracture method and platelet-rich fibrin in autotransplantation of mature teeth on pulp revascularization clinically and radiologically during a 1-year observation period. Material and method: Forty mature teeth in 38 patients (20 females, 18 males) aged 19-45 years were included in this prospective cohort study. 3D resin models of the donor tooth were created with 3D imaging methods and used in the preparation of the recipient socket. Afterwards, the donor tooth was extracted and its apex was exposed by the fragile fracture method. Leukocyte-platelet-rich fibrin (L-PRF) was placed in the recipient socket and the donor tooth was placed in the socket and fixed with suture or splint. The patients were followed up periodically in terms of findings such as survival, vitality, root resorption, ankylosis, periodontal pocket and new lesion formation over a 1-year period. Results: At the end of the first year, it was observed that 82.5% of the ODT-treated teeth were maintained in the mouth and the pulp of 60% was vital. Root resorption was observed in 47.5% of the teeth, ankylosis in 22.5% and new lesion formation in 27.5%. While brushing teeth more than once a day and having a high school or higher education had a positive effect on the maintenance of the teeth, having diabetes and the presence of resorption in the buccal bone in the recipient area (before the procedure) adversely affected it. Age below 25 had a positive effect on pulp vitality. While the amount of repeated attempts of the donor tooth in the recipient socket increased the rate of resorption, the presence of buccal bone resorption in the recipient area before the procedure increased pathological mobility and new lesion formation. Conclusion: In autotransplantation performed with the fragile fracture method applied to mature teeth, pulp vitality can be gained as in immature teeth and a good postoperative result can be obtained. Current approaches such as 3D imaging/modelling and the use of autologous blood products, in addition to the fragile fracture method in autotransplantation, may improve clinical outcomes. Keywords: tooth autotransplantation, mature tooth, fragile fracture, apicoectomy, PRF, pulp revascularisation, 3D model.