Criteria and prognostic factors for survival and success rates for autotransplantation in the area of first and second molars
a systematic review and meta-analysis
DOI:
https://doi.org/10.61872/sdj-2025-01-05PMID:
40072289Keywords:
autotransplantation, immature third molars, survival rate, success rate, prognostic factorsAbstract
Autotransplantation of immature third molars is an effective treatment option, offering high success rates, minimal complications, and notable improvements in occlusal function and dental aesthetics. This study aims to review and evaluate the available evidence specifically on the survival and success rates of immature autotransplanted third molars and to identify prognostic factors that influence these outcomes.
A comprehensive search was conducted in the Elsevier Journals (ScienceDirect), MEDLINE (PubMed), and Dentistry & Oral Sciences Source (EBSCOhost) databases up to May 2024. Risk of bias within studies was asse ssed with the CASP guidelines. Nine studies met the inclusion criteria for qualitative and quantitative analysis. The pooled survival rate was consistently high across studies, estimated at 91.867% (95% CI: 85.058% to 96.741%), while the success rate, though slightly lower, remained substantial at 90.162% (95% CI: 79.813% to 97.067%).
Key prognostic factors identified include the developmental stage of the donor teeth (Moorrees stages from R ¼ to Rc), showing enhanced success due to better potential for pulp revascularization and continued root growth. Additionally, innovative techniques, including advanced methods like computer-aided rapid prototyping (CARP) and platelet-rich plasma (PRP), were found to positively impact healing and integration. Fixation methods also played a role, as excessive rigid fixation was linked to higher rates of ankylosis and inflammatory root resorption.
Future research should prioritize recipient site and donor tooth characteristics, standardized success criteria, extended follow-up periods, and refined treatment protocols to enhance predictability and long-term outcomes in teeth autotransplantation.
References
1. Kafourou V, Tong HJ, Day P., Houghton N , Spencer RJ, Duggal M. Outcomes and prognostic factors that in-fluence the success of tooth autotransplantation in children and adolescents. Dent Traumatol. 2017;33(5): 393-399.
2. Fong C.C. Transplantation of the third molar. Oral Surg Oral Med Oral Pathol. 1953;6(8):917-926.
3. Apfel H. Preliminary work in transplanting the third molar to the first molar position. J Am Dent Assoc. 1954;48(2):143-150.
4. Kristerson L, Johansson LA, Kisch J, Stadler LE. Autotransplantation of third molars as treatment in advanced periodontal disease. J Clin Periodontol. 1991;18(7):521-528
5. Erdem NF, Gümüşer Z. Retrospective evaluation of immediate impacted third molars autotransplantation after extractions of mandibular first and/or second molars with chronic periapical lesions. J Oral Maxillofac Surg. 2021;79(1):37-48.
6. Dioguardi M, Quarta C, Sovereto D. Autotransplantation of the third molar: A therapeutic alternative to the rehabilitation of a missing tooth: A scoping review. Bioengineering. 2021;8(9):120.
7. Boschini L, Melillo M, Berton F. Long-term survival of mature autotransplanted teeth: A retrospective single-center analysis. J Dent. 2020; 98:103371.
8. Chung W.-C., Tu Y.-K., Lin Y.-H., Lu H.-K. Outcomes of autotransplanted teeth with complete root formation: a systematic review and meta-analysis. Journal of Clinical Periodontology. 2014;41(4):412–423. doi: 10.1111/jcpe.12228.
9. Barber, S. K., Kenny, K., Czochrowska, E., Plakwicz, P., Houghton, N. Y., & Day, P. F. (2023). Identifying im-portant prognostic factors and outcomes for autotransplantation of developing teeth: Clinicians' perspectives. Dental traumatology: official publication of International Association for Dental Traumatology, 39 Suppl 1, 30–39. https://doi.org/10.1111/edt.12843
10. Algubeal HM, et al. Autotransplantation of the lower posterior teeth: a comprehensive review. Cureus. 2022;14(8).
11. Mendes RA, Rocha G. Mandibular third molar autotransplantation--literature review with clinical cases. J Can Dent Assoc. 2004;70(11):761-766.
12. Reich PP. Autogenous transplantation of maxillary and mandibular molars. J Oral Maxillofac Surg. 2008;66(11):2314-2317.
13. Bauss O, Zonios I, Engelke W. Effect of additional surgical procedures on root development of transplanted immature third molars. Int J Oral Maxillofac Surg. 2008; 37:730-735.
14. Isa-Kara M, Sari F, Emre-Coşkun M. Stabilization of autotransplanted teeth using thermoplastic retainers. Med Oral Patol Oral Cir Bucal. 2011;16(3).
15. Schütz S, Beck I, Kühl S, Filippi A. Results after wisdom tooth transplantation. A retrospective study. Schweiz MonatsschrZahnmed. 2013;123(4):303-313.
16. Jang JH, Lee SJ, Kim E. Autotransplantation of immature third molars using a computer-aided rapid prototy-ping model: A report of 4 cases. J Endod. 2013;39(11):1461-1466.
17. Nimčenko T, Omerca G, Bramanti E, Cervino G, Laino L, Cicciù M. Autogenous wisdom tooth transplantation: A case series with 6-9 months follow-up. Dent Res J. 2014;11(6):705.
18. Nagori SA, Bhutia O, Roychoudhury A, Pandey RM. Immediate autotransplantation of third molars: an expe-rience of 57 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(4):400-407.
19. Gonzalez-Ocasio J, Stevens M. Autotransplantation of third molars with platelet-rich plasma for immediate replacement of extracted non-restorable teeth: A case series. J Oral Maxillofac Surg. 2017;75(9): 1833.e1-1833.e6.
20. Raabe C, Bornstein MM, Ducommun J, Sendi P, von Arx T, Janner SFM. A retrospective analysis of autotrans-planted teeth including an evaluation of a novel surgical technique. Clin Oral Investig. 2021; 25:3513-3525.
21. Zhang J, et al. The effect of aging on the pluripotential capacity and regenerative potential of human perio-dontal ligament stem cells. Biomaterials. 2012;33(29):6974-6986.
22. Lejnieks M, Akota I, Jākobsone G, Neimane L, Uribe SE. Clinical Efficacy of CBCT and 3D-Printed Replicas in Molar Autotransplantation: A Controlled Clinical Trial. Dent Traumatol. 2024 Nov 6. doi: 10.1111/edt.13012. Epub ahead of print. PMID: 39506454.
23. Chung WC, Tu YK, Lin YH, Lu HK. Outcomes of autotransplanted teeth with complete root formation: A syste-matic review and meta-analysis. J Clin Periodontol. 2014;41: 412-423.
24. Mertens B, Boukari A, Tenenbaum H. Long-term follow-up of post-surgical tooth autotransplantation: A retro-spective study. J Investig Clin Dent. 2016;7: 207-214.
25. Kamio T, Kato H. Autotransplantation of impacted third molar using 3D printing technology: A case report. Bull Tokyo Dent Coll. 2019;60(3):193-199.
26. Wang L, et al. Clinical outcomes after intentional replantation of permanent teeth: A systematic review. Bosn J Basic Med Sci. 2020;20(1):13-20.
27. Rohof ECM, KerdijkW , Jansma J, Livas C, RenY . Autotransplantation of teeth with incomplete root formati-on: a systematic review and meta-analysis. Clin Oral Investig. 2018;22: 1613-1624.
28. ZhangJ, AnY, GaoL-N, ZhangY-J, JinY, Chen FM. The effect of aging on the pluripotential capacity and regene-rative potential of human periodontal ligament stem cells. Biomaterials. 2012;33(29):6974-6986.
29. Tan BL, Tong HJ, Narashimhan S, Banihani A, Nazzal H, Duggal MS. Tooth autotransplantation: An umbrella review. Dent Traumatol. 2023; 39:2-29.
30. Almpani K, Papageorgiou SN, Papadopoulos MA. Autotransplantation of teeth in humans: A systematic re-view and meta-analysis. Clin Oral Investig. 2015;19: 1157-1179
31. Atala-Acevedo C, Abarca J, Martínez-Zapata MJ, Díaz J, Olate S, Zaror C. Success rate of autotransplantation of teeth with an open apex: Systematic review and meta-analysis. J Oral Maxillofac Surg. 2017;75(1):35-50.
32. Sicilia-Pasos J, KewalramaniN, Peña-CardellesJ-F, Salgado-PeralvoA-O, Madrigal-Martínez-Pereda C, López-CarpinteroÁ. Autotransplantation of teeth with incomplete root formation: Systematic review and meta-analysis. Clin Oral Investig. 2022;26(5):3795-3805
33. Jaber M, Prasad P, Akeil M, Moufti A, Al-Sammarraie A, Eddin CC. Long-term evaluation of tooth transplanta-tion: An umbrella review. J Clin Med. 2024;13(11):3341.
34. Pineda-Vélez E, Vivares AM, Casillas-Castillo JV. Success predictive factors of teeth subjected to autotrans-plant: An umbrella review. Saudi Endod J. 2024;14(2):145-152.
35. Aravena-Salazar JP, Matus-Miranda G, Dethlefs-Canto J, Niklander SE. New complementary alternatives in third molar autotransplantation: A systematic review. Med Oral Patol Oral Cir Bucal. 2024;29(2): e241-e247.
36. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, HoffmannTC,MulrowC. Det al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372: n71.
37. Schiavenato M, Chu FP. PICO: What it is and what it is not. Nurse Educ Pract. 2021;56: 103194.
38. Critical Appraisal Skills Programme (CASP). CASP (Case Control Studies and Retrospective Studies) Checklist. 2018. Available at: https://casp-uk.net/casp-tools-checklists/ [Accessed 18 Nov. 2024].
39. Arrais M, Maricoto T, NwaruBI et al. Helminth infections and allergic diseases: Systematic review and meta-analysis of the global literature. J Allergy Clin Immunol. 2022;149(6):2139-2152.
40. Plakwicz P, Wojtowicz A, Czochrowska EM. Survival and success rates of autotransplanted premolars: a pros-pective study of the protocol for developing teeth. Am J OrthodDentofacOrthop. 2013;144(2):229-237.
41. Machado LA, do Nascimento RR, Ferreira DM, Mattos CT, Vilella OV. Long-term prognosis of tooth autotrans-plantation: A systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2016;45(5):610-617.
42. Schwartz O. Cryopreservation as long-term storage of teeth for transplantation or replantation. Int J Oral Maxillofac Surg. 1986;15(1):30-32.
43. Schwartz O, Rank CP. Autotransplantation of cryopreserved tooth in connection with orthodontic treatment. Am J OrthodDentofacOrthop. 1986;90(1):67-72.
44. Aslan H, Coval M, Shemesh A, Webber M, Birnboim-Blau G. Ankylosed permanent teeth: incidence, etiology and guidelines for clinical management. Med Dent Res 1.1 2018; 1-11.
45. Checchi L, Montevecchi M, Checchi V, Zappulla F. The relationship between bleeding on probing and sub-gingival deposits. An endoscopical evaluation. Open Dent J. 2009 Jul 28;3: 154-60. doi: 10.2174/1874210600903010154. PMID: 19672332; PMCID: PMC2724644.
46. Peck C. C. Biomechanics of occlusion–implications for oral rehabilitation //Journal of oral rehabilitation. – 2016. – Т. 43. – №. 3. – С. 205-214.
47. Bastos, Juliana Vilela, and Maria Ilma de Souza Côrtes. "Pulp canal obliteration after traumatic injuries in permanent teeth–scientific fact or fiction?" Brazilian oral research 32 (2018): e75.
48. Anitua E., Piñas L., Alkhraisat M. H. A Novel Technique for Preparation of Recipient Site and Autologous Bone Grafting in Autotransplantation of Single-Rooted Teeth: A Report of Two Cases //Cureus. – 2022. – Т. 14. – №. 11.
49. Moorrees CFA, Fanning EA, Hunt Jr EE. Age variation of formation stages for ten permanent teeth. J Dent Res. 1963;42(6):1490-1502.
50. Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol. 1973;45(2):211-227.
51. Abella F, Ribas F, Roig M, González Sánchez JA, Durán-Sindreu F. Outcome of autotransplantation of mature third molars using 3-dimensional–printed guiding templates and donor tooth replicas. J Endod. 2018;44(10):1567-1574.
52. Mejàre B, Wannfors K, Jansson L. A prospective study on transplantation of third molars with complete root formation. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2004; 97:231-238.
53. Akkocaoglu M, Kasaboglu O. Success rate of autotransplanted teeth without stabilization by splints: a long-term clinical and radiological follow-up. Br J Oral Maxillofac Surg. 2005; 43:31-35.
54. Teixeira CS, Pasternak B Jr, Vansan LP. Autogenous transplantation of teeth with complete root formation: two case reports. Int Endod J. 2006; 39:977-985.
55. Andreasen JO. A long-term study of 370 autotransplanted premolars. Eur J Orthod. 1990; 12:3-50.
56. Singh AK, Khanal N, Acharya N, Hasan MR, Saito T. What are the complications, success, and survival rates for autotransplanted teeth? An overview of systematic reviews and metanalyses. Healthcare. 2022;10(5):835.
57. Kakde K, Rajanikanth K. Tooth autotransplantation as an alternative biological treatment: A literature review. Cureus. 2022;14(10).
58. Volponi AA, Pang Y, Sharpe PT. Stem cell-based biological tooth repair and regeneration. Trends Cell Biol. 2010;20(12):715-722.
59. Krakowiak FJ. Ankylosed primary molars. ASDC J Dent Child. 1978;45(4):288-292.
60. Messer LB, Cline JT. Ankylosed primary molars: results and treatment recommendations from an eight-year longitudinal study. Pediatr Dent. 1980;2(1):37-47.
61. Quinzi, V., Panetta, G., Filippi, P., Rizzo, F. A., Mancini, L., &Mummolo, S. (2020). Autotransplatation of imma-ture third molars as substitutes for congenitally missing second premolars: an alternative solution in a young patient with oligodontia. Journal of biological regulators and homeostatic agents, 34(3 Suppl. 1), .
62. Putrino, A., Marinelli, E., Agrillo, A., &Zaami, S. (2024). New Perspectives in Third Molar Auto-Transplantation: Literature Review and a Case Report of Clinical, Financial and Forensic Implications. Medici-na (Kaunas, Lithuania), 60(3), 473. https://doi.org/10.3390/medicina60030473
63. Muhsin, H., &Brizuela, M. (2023). Oral Surgery, Extraction of Mandibular Third Molars. In StatPearls. StatPearls Publishing.
64. Alencastro S. A. M., Rockenbach M. C. Complications in the extraction of impacted, and retained third mo-lars. Literature Review. [English translation-Original in Spanish] //Odontología Vital. – 2023. – Т. 1. – №. 38. – С. 26-33.
65. Nomura LH, do Amaral ROJF, Andrade CF, Morais ND, Baratto-Filho F, Leonardi D. Regenerative endodontic treatment of teeth with incomplete root formation: a review //RSBO Revista Sul-Brasileira de Odontologia. 2016;13(3):199-208.
66. Pogrel M.A. Evaluation of over 400 autogenous tooth transplants. J. Oral Maxillofac. Surg. 1987; 45:205–211. doi: 10.1016/0278-2391(87)90116-9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Darja Gostilo, Prof. Gundega Jākobsone
This work is licensed under a Creative Commons Attribution 4.0 International License.
