Background and objectives : Tooth autotransplantation has developed into a safe and predictable procedure, which preserves the continuity of the dental arch and the alveolar process and provides an acceptable esthetic and physiologic outcome. The aim of this study is to describe our experience with the developing premolar autotransplantation into the iliac crest grafted alveolar cleft and compare it with previously reported cases.

Methods : Four cleft affected patients were referred to the Orthodontic and Craniofacial Department, Rambam Health Care Campus, Haifa, Israel due to loss of teeth in the cleft area. In all cases, orthodontic closure of the missing teeth space in the maxillary dental arch was considered inappropriate and therefore autotransplantation of the extracted mandibular premolar into the grafted alveolar cleft site was conducted. Tooth autotransplantation has developed into a safe and predictable procedure, which preserves the continuity of the dental arch and the alveolar process and provides an acceptable esthetic and physiologic outcome. our experience with the developing premolar autotransplantation into the iliac crest grafted alveolar cleft and compare it with previously reported cases.

Results : All the transplanted teeth in the reported cleft affected patients presented no signs or symptoms of progressive root pathology or gingival disease and advanced tooth mobility. Long-term clinical follow-up examination revealed improved facial esthetics and occlusal relationships along with increased self-esteem and welfare of the patients’ with no need for future dental restorative treatment.

Conclusions : Autotransplantation of premolars should be considered an alternative to prosthodontics in cleft affected patients.

Key words: alveolar cleft; tooth autotransplantation; bone graft; mandibular premolar