Optimizing Pulp Management in Autotransplantation of Mature Third Molars: A Randomized Controlled Trial

Optimizing Pulp Management Strategies for Autotransplantation of Fully Developed Third Molars: A Three-Arm Randomized Controlled Trial

This study aims to find the best way to use your own healthy wisdom tooth to replace the bad tooth. After transplantation, how to manage the "tooth nerve" (dental pulp) inside the tooth is a key question. Currently, doctors have three different management strategies, but it is not clear which one is most beneficial for long-term success.

This study will compare these three strategies:

Performing standard root canal treatment (removing the tooth nerve) a few weeks after transplantation.

Performing a special procedure to treat and fill the root tip during the transplant surgery, followed by root canal treatment later.

Simply trimming the root tip during the transplant surgery, hoping to preserve the vitality of the tooth nerve and thereby avoid subsequent root canal treatment.

If you agree to participate, you will be randomly assigned to one of these groups to receive treatment. Afterwards, we will need to schedule regular check-ups for you over a period of 5 years (including X-rays and examinations) to monitor the healing of the transplanted tooth, check for any problems, and assess the status of the tooth nerve.

Your participation will help us identify the most effective and long-lasting treatment method, thereby benefiting future patients in similar situations.

Inclusion Criteria:

1. Aged 18-40 years.
2. Requires extraction of a non-restorable first or second molar AND possesses a fully developed, morphologically healthy ipsilateral third molar as a donor tooth.
3. Willing and able to provide written informed consent.

Exclusion Criteria:

1. Presence of acute infection or insufficient bone volume at the recipient site.

2. Donor tooth exhibits caries, periapical pathology, or periodontal disease.

3. Uncontrolled systemic disease (e.g., diabetes, immunosuppression), pregnancy, or lactation.

   Smoking habit of >10 cigarettes per day.

4. Inability or unwillingness to comply with the long-term follow-up schedule.