Histopathological and immunological aspects of tooth transplantation

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Abstract
Histopathological studies of teeth transplanted between genetically identical and dissimilar animals and to animals in which the immune response is suppressed or enhanced show that autografts and isogratts degenerate but then are repaired, whereas allografts show a bewildering array of changes from almost total destruction to total repair. Some explanations for the repair of teeth in an immunologically hostile environment are put forward.The immunological aspects of tooth transplantation are also reviewed. Transplanted teeth stimulate an immune response from the host and are subject to the same rules of genetic relationship which apply to other tissues. Most components of the teeth are antigenic in isolation but only the pulp and periodontal ligament have so far been demonstrated to possess these properties in viro. Transplanted teeth also elicit antibody formation but the importance of antibodies in the rejection process is still disputed.It is concluded that teeth are not immunologically privileged tissues but will elicit cell‐mediated responses from allogeneic hosts and are subject to the same invasive‐destructive lesions as a result. The peculiar observations of repair of allogeneic teeth and delayed immune responses can be explained by considering the histopathology of transplanted teeth and their capacity for repair.Finally, the use of transplanted teeth to study odontogenesis and pathological entities such as odontogenic cysts and reparative dentin formation are briefly reviewed.