Orthotown December 2019 - 23
The first time I did this upper 5 autotransplant routine was the son of a local MD. Mom was
in for the initial visit and I suggested autotransplantation, figuring I would have a major issue
with Dad. Just the opposite-he came in for the treatment conference more excited about it than
I was. He told me he searched the literature, and this was something that really worked. "Let's
do it," he said. Worked out great.
Hard part is finding a surgeon to do it. I use Peter Reich of Dover, NH. He has done almost
a dozen autotransplants for me over the years. If autotransplants are not going to work or you
can't find a surgeon, extract the lower Es now and hold space with an LA with the idea of doing
implants some day in the lower 5 position. Trying to close the lower space is using ortho for a
prostho problem and that doesn't always work. ■
10/10/2019
I would extract UDs, LEs right away and then the upper 4s. Most of the lower space will
close by "driftodontics." Upper may need a Nance once the Es are close to exfoliating (unless
she's ready to be started). Once the teeth are in, minimal anchorage mechanics on the upper and
lower would be the goal. ■
Fenrisúlfr
Member Since: 02/25/09
Post: 5 of 26
10/10/2019
Yes, but for us mortals, we may not be able to achieve this. Fen, I have tried protraction cases
and failed in spectacular fashion before. I'm always careful about case selection now. Maybe I
should keep trying, but the success rate for me has been hit or miss. I like Charlie's approach of
it being a restorative problem or an autotransplant issue.
Again, Fen, you are capable of things us mortals are not. ■
justinudm
Member Since: 09/29/14
Post: 6 of 26
10/10/2019
Extraction of URD, E and ULD. Hold space with retainer and monitor growth/development.
I have no personal experience with decoronization, but this may be a case where I would consider
it for the lower Es to preserve the ridge for future implants/restoration. If you search this site,
you can find more info regarding decoronization that others have been kind enough to link. ■
Sláinte
Member Since: 07/30/09
Post: 7 of 26
10/10/2019
The conversation continues online!
Townies came together and shared a great deal of advice thanks
to "SNP15"and her complicated case. If you would like to weigh in
or see how she proceeded, go to orthotown.com/magazine and
find a link to this message board in the December lineup.
orthotown.com \\ DECEMBER 2019
23
http://www.orthotown.com/magazine
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Orthotown December 2019
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