Autotransplantation of teeth in humans: a systematic review and meta-analysis
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The aim of this investigation was to assess the currently available evidence concerning the complications and risk factors influencing the outcome of autotransplantation of teeth in humans.
Materials and methods
Electronic searches were conducted to identify randomized controlled and prospective clinical trials. Risk of bias within studies was assessed with the Downs and Black tool. Random-effects meta-analyses were conducted to pool the adverse event rates and relative risks with their 95 % confidence intervals. Risk of bias across studies was assessed with the GRADE framework followed by sensitivity analyses.
Thirty-eight studies were included in the analysis. Reported complications included the need for extraction, failure, hypermobility, pulp necrosis, pulp obliteration, and root resorption. Pooled complication event rates varied considerably, with small studies (<100 teeth) reporting greater complication rates. The analysis of risk factors was associated with both the primary outcome (extraction need) and secondary outcomes (failure, hypermobility, pulp necrosis, pulp obliteration, root resorption). The stage of root development seems to influence both the future survival, as well as the success of the transplanted teeth. Teeth with open apex were less likely to be extracted in comparison to teeth with closed apex (3 studies; 413 teeth; relative risk 0.3; 95 % confidence interval 0.2–0.6).
Due to the small number of the contributing studies, their methodological limitations, and the heterogeneous results reported, no firm conclusions can be drawn.
Root development of the donor teeth has been established as one the most important factor related to the success of tooth autotransplantation.
KeywordsAutotransplantation Teeth Transplantation Root development Pulp necrosis Pulp obliteration Root resorption
Conflict of interest
The authors declare that they have no conflict of interest.
- 36.Yoshino K, Ishizuka Y, Sugihara N, Kariya N, Namura D, Noji I, Mitsuhashi K, Kimura H, Fukuda A, Kikukawa I, Hayashi T, Yamazaki N, Kimura M, Tsukiyama K, Yamamoto K, Fukuyama A, Hidaka D, Shinoda J, Mibu H, Shimakura Y, Saito A, Ikumi S, Umehara K, Kamei F, Fukuda H, Toake T, Takahashi Y, Miyata Y, Shioji S, Toyoda M, Hattori N, Nishihara H, Matsushima R, Nishibori M, Hokkedo O, Nojima M, Kimura T, Fujiseki M, Okudaira S, Tanabe K, Nakano M, Ito K, Kuroda M, Fukai KMT (2013) Gender difference in tooth autotransplantation with complete root formation: a retrospective survey. J Oral Rehabil 40:268–274. doi: 10.1111/joor.12038 Google Scholar
- 38.Oksala E, Kallioniemi H (1977) A longitudinal clinical and radiographic study of autotransplantation of the maxillary canine. Proc Finnish Dent Soc 73:117–125Google Scholar
- 47.Andreasen JO (1992) Atlas of replantation and transplantation of teeth. Mediglobe, Fribourg, pp 111–137Google Scholar
- 67.Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0Google Scholar
- 68.Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis J, Clarke M, Devereaux P, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34. doi: 10.1016/j.jclinepi.2009.06.006 PubMedCrossRefGoogle Scholar
- 69.Beller EM, Glasziou PP, Altman DG, Hopewell S, Bastian H, Chalmers I, Gøtzsche PC, Lasserson T, Tovey D; PRISMA for Abstracts Group (2013) PRISMA for Abstracts: reporting systematic reviews in journal and conference abstracts. PLoS Med 10, e1001419. doi: 10.1371/journal.pmed.1001419 CrossRefGoogle Scholar
- 85.Jacobson A, Graber TM (1993) Atlas of replantation and transplantation of teeth: J. O. Andreasen, O. Schwartz, H. U. Paulsen, and B. U. Zachrisson Switzerland: Mediglobe SA (English edition WB Saunders). ISBN 2-88239-015-X. 306 pages. Illustrated and index. Am J Orthod Dentofac Orthop 103:293Google Scholar