Autotransplantation of teeth is a potential treatment option in patients with missing teeth. Unlike dental implants autotransplantation can be performed in growing patients and the longevity of autotransplantation is comparable.
The aim of this systematic review and meta-analysis were to determine the 1-, 5-, and 10-year and overall survival rates, the overall success rate, and the complication rates of autotransplantation of teeth with incomplete root formation, and to identify the prognostic factors that influence the survival and success.
Methods
Searches were conducted in the PubMed, Cochrane Library and Web of Science databases. Prospective and retrospective studies including randomized clinical trials (RCTs), controlled clinical trials (CCTs), and case series (CS); involving five or more participants and at least ten permanent transplanted teeth with incomplete root formation with at least 1 years follow up were considered.
Two reviewers independently screened and selected studies and abstracted data. Study quality was assessed using the Newcastle-Ottawa scales as no RCTs were identified. Root development was recorded using the classification as described by Moorrees. Survival was defined as tooth presence during follow-up. Success being defined as the presence of the tooth in the mouth without ankylosis or inflammatory root resorption, normal mobility, and continuation of root development during the follow-up period. Weighted average rates per year of success and survival were determined as well as the weighted average 1-, 5-, and 10-year survival.
Results
- 32 studies (15 prospective, 16 retrospective cohorts, 1 case series) were included
- Only 5 studies were considered to be of high quality.
- The weighted estimated survival rate per year was 98.2% (95% CI, 96.4–99.1%)
| No of studies | Average weighted survival rate (95% CI) | |
| 1 year | 26 | 97.4% (96.2–98.2%) |
| 5 years | 11 | 97.8% (95.0–99.0%) |
| 10 years | 6 | 96.3% (89.8–98.7%) |
- Weighted estimated yearly success rate was = 96.6% (95% CI, 94.8–97.8).
- Weighted estimated ankylosis = 2.0% (95% CI, 1.1–3.7%).
- Weighted estimated root resorption = 2.9% (95% CI, 1.5–5.5%).
- Weighted estimated pulp necrosis = 3.3% (95% CI, 1.9–5.6%).
Conclusions
The authors concluded: –
autotransplantation of teeth with incomplete root formation could be considered as a treatment option for tooth replacement. One-, 5-, and 10-year survival and success rates were high (> 90%) and complications in terms of ankylosis, root resorption, and pulp necrosis were very low. Premolars were slightly preferred over molars as donor teeth. Existing evidence on prognostic factors such as stage of root formation, postsurgical stabilization methods, and orthodontic treatment is insubstantial to merit a firm conclusion.
Comments
Yearly this year we have previously considered two reviews looking at autotransplantation of teeth ( Dental Elf – 2nd Mar and 11th Jun 2018 ) One of these focussed specifically on canines the other on transplantation into the anterior maxilla. The current review looked at the topic more broadly using an extensive unrestricted search. Given the nature of the intervention prospective cohort studies are likely to be the best approach for assessing outcomes but these represented only 50% of the included studies. the author also note that only retrospective studies were available to assess the longer term outcomes. While the analysis suggests good long terms survival rates the included studies involved only a small number of patients and only 5 of the studies were considered to be of high quality so the findings should be interpreted cautiously.
Links
Primary Paper
Rohof ECM, Kerdijk W, Jansma J, Livas C, Ren Y. Autotransplantation of teeth with incomplete root formation: a systematic review and meta-analysis. Clin Oral Investig. 2018 May;22(4):1613-1624. doi: 10.1007/s00784-018-2408-z. Epub 2018 Mar10. Review. PubMed PMID: 29525924; PubMed Central PMCID: PMC5906482.
Other references
Moorrees CF, Fanning EA, Hunt EE j. Age variation of formation stages for ten permanent teeth. J Dent Res. 1963 Nov-Dec;42:1490-502. PubMed PMID: 14081973.
Dental Elf – 11th Jun 2018
Dental Elf – 2nd Mar 2018
