FEATURE ARTICLE
OUTCOMES OF AUTOTRANSPLANTED THIRD MOLARS WITH COMPLETE ROOT FORMATION: A SYSTEMIC REVIEW AND META‐ANALYSIS

https://doi.org/10.1016/j.jebdp.2023.101842Get rights and content

Highlights

  • •

    Autogenous tooth transplantation of mature third molars provides reliable outcomes.

  • •

    A promising long-term survival rate of ATT with mature third molars is achievable.

  • •

    The use of 3D techniques can reduce the root resorption and ankyloses rates.

  • •

    An appropriate indication and patient selection are crucial for success.

Abstract

Objectives

Clear evidence is lacking regarding the outcomes of autogenous tooth transplantation (ATT) of third molars with complete root formation. The current review aims to explore the long-term survival and complication rates.

Methods

A comprehensive search was performed in December 2022 of the PubMed, Scopus, Embase, EBSCO, Ovid, Science Direct, and Web of Science databases. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered at the International Prospective Register of Systematic Reviews (CRD42022337659). The pooled survival, root resorption, and ankyloses rates were calculated. Subgroup analyses were performed to explore the effects of sample size and 3D techniques.

Results

Twelve studies from 5 countries fulfilled the eligibility, with 759 third molars transplanted in 723 patients. Five studies reported 100% survival at 1-year follow-up. After excluding these 5 studies, the pooled survival rate was 93.62% at 1 year. The survival rate of 1 large sample study was significantly higher than that of small ones at 5 years. The complications of studies using 3D techniques were: root resorption 2.06% (95% CI: 0.22, 7.50) and ankyloses 2.81% (95% CI: 0.16, 12.22), compared to those without 3D techniques: root resorption 10.18% (95% CI: 4.50, 17.80) and ankyloses 6.49% (95% CI: 3.45, 10.96).

Conclusions

ATT of third molars with complete root formation is a reliable alternative for replacement of a missing tooth and has a promising survival rate. The use of 3D techniques can reduce complication rates and improve long-term survival.

Access through your organization

Check access to the full text by signing in through your organization.

Access through your institution

Section snippets

INTRODUCTION

Autogenous tooth transplantation (ATT), a therapeutic strategy to replace a non-restorable or missing tooth with restricted indications, was first reported in 1950.1 It is defined as the surgical movement of an embedded or erupted donor tooth to a recipient site in the same individual, essentially a controlled extraction and reimplantation in an extraction site or surgically prepared socket.2, 3, 4, 5 Viable but malpositioned teeth—including third molars, premolars, canines, and supernumerary

Protocol and Registration

A literature search, study selection, data extraction, and reporting of the results were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.18 The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (no. CRD42022337659). The protocol was designed to answer the following questions: What are the long-term survival and complication rates of ATT using third molars with complete

Study Selection

The electronic searches yielded 176 articles. After we discarded 118 duplicates, 58 articles were screened based on the titles and abstracts, which resulted in 24 articles for full-text assessment. One article was not retrievable even with the assistance of an experienced librarian, and 1 was retracted. Subsequently, 13 potentially relevant studies were excluded, leaving 9 studies. A manual search of related articles in PubMed yielded 3 studies. Therefore, 12 studies met the inclusion criteria

DISCUSSION

ATT is a valid treatment strategy for tooth replacement, being more economical, biological, and esthetic than prosthetic rehabilitation.38 The indications for ATT include impacted or ectopic teeth, premature and/or traumatic tooth loss, loss of teeth because of tumors or on iatrogenic grounds, congenitally missing teeth in one arch in combination with a discrepancy in arch length or clinical signs of tooth crowding on the opposing arch, replacement of teeth with a bad prognosis, and/or

CONCLUSIONS

ATT of third molars with complete root formation is a reliable alternative for the replacement of a missing tooth and has a promising survival rate. The use of 3D techniques can improve the precision of the surgical procedure and reduce the complication rate, which makes long-term success more likely. An appropriate indication and patient selection are crucial for successful ATT of third molars with complete root formation. However, since the available published evidence is of a limited level

AUTHOR CONTRIBUTIONS

JH and ZC contributed to the conception and study design. JH, HX, and YG screened and reviewed the studies. JH, YG, and DL conducted the data extraction and statistical analysis. YG, YY, and DL assessed the quality of the included studies. SH, HZ, and XT checked the quality of the methodology. JH and HX drafted the manuscript. NL critically revised the manuscript. All authors approved the final version of the manuscript and its submitted form.

References (53)

  • Y. Jang et al.

    Prognostic factors for clinical outcomes in autotransplantation of teeth with complete root formation: survival analysis for up to 12 years

    J Endodont

    (2016)
  • Ö. Kırmalı et al.

    Finite element analysis of stress distribution in autotransplanted molars

    J Dent

    (2022)
  • S. Kim et al.

    Vertical bone growth after autotransplantation of mature third molars: 2 case reports with long-term follow-up

    J Endod

    (2015)
  • L. Boschini et al.

    Endodontic management of an autotransplanted mandibular third molar: a simplified approach

    J Am Dent Assoc

    (2020)
  • L. Boschini et al.

    Long term survival of mature autotransplanted teeth: a retrospective single center analysis

    J Dent

    (2020)
  • S.A. Nagori et al.

    Immediate autotransplantation of third molars: an experience of 57 cases

    Oral Surg Oral Med Oral Pathol Oral Radiol

    (2014)
  • H. Apfel

    Autoplasty of enucleated prefunctional third molars

    J Oral Surg (Chic)

    (1950)
  • M. Tsukiboshi

    Autotransplantation of teeth: requirements for predictable success

    Dent Traumatol

    (2010)
  • G. Plotino et al.

    Clinical procedures and outcome of surgical extrusion, intentional replantation and tooth autotransplantation – a narrative review

    Int Endod J

    (2020)
  • G. Plotino et al.

    Present status and future directions: surgical extrusion, intentional replantation and tooth autotransplantation

    Int Endod J

    (2022)
  • S.A. Nagori et al.

    Evaluating success of autotransplantation of embedded/impacted third molars harvested using piezosurgery: a pilot study

    Acta Odontol Scand

    (2014)
  • M. Tsukiboshi

    Autotransplantation of teeth: requirements for predictable success

    Dent Traumatol

    (2002)
  • W. He et al.

    Computer-aided autotransplantation of teeth with 3D printed surgical guides and arch bar: a preliminary experience

    Peer J

    (2018)
  • R.A. Mendes et al.

    Mandibular third molar autotransplantation–literature review with clinical cases

    J Can Dent Assoc

    (2004)
  • G.T.M. Candeiro et al.

    Eight-year follow-up of autogenous tooth transplantation involving multidisciplinary treatment

    J Oral Sci

    (2015)
  • J.H. Park et al.

    Tooth Autotransplantation as a Treatment Option: a Review

    J Clin Pediatr Dent

    (2010)

    • Cited by (4)

    Source of Funding: Not reported.

    Conflict of Interest: The authors have no actual or potential conflicts of interest.

    View full text
    © 2023 Elsevier Inc. All rights reserved.