Sir, a 36-year-old male attended as a new patient to my practice in 2012, complaining that he had a fractured tooth on the lower right side.

After clinical and radiographic examination it became clear that there was a large carious lesion in the distal of the lower right second molar tooth and also a mesially impacted lower right third molar (Fig. 1).

Figure 1
figure 1

Mesially impacted lower right third molar

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After much discussion we planned to extract the carious second molar and also the poorly positioned third molar tooth.

I saw the patient the following week and the second molar tooth was extracted with curettage of the socket.

The third molar was then extracted and on removal, the socket of second molar tooth 'begged me' to try the third molar in for fit.

It seated very nicely, so I stopped the procedure with the tooth still in the socket and discussed the pros and cons of attempting a transplantation procedure.

The patient was keen to give it a go and I bonded the third molar to the distal of the first molar with composite resin. The patient was advised not to load the teeth on that side (Fig. 2).

Figure 2
figure 2

Third molar transplant to second molar pocket

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I saw him for review some two months later and removed the composite splint. There was some slight mobility of the tooth, but no discomfort.

A radiograph showed some bony infill. I advised him that the tooth required root canal treatment but we decided to leave the tooth for a further couple of months before attempting this procedure.

At his next visit, the tooth was much more firm. The root canal treatment was performed and the tooth settled uneventfully (Fig. 3).

Figure 3
figure 3

Settled transplanted third molar post RCT

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I saw him for examination in May this year (five years post-operatively) and the tooth is still doing well. The radiograph shows complete bony infill and no signs of resorption.

He is delighted that he has his own tooth there and not a dental implant!