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Immediate Tooth Autotransplantation into Fresh Extraction Sockets: A Case Series and Literature Review

Autologous tooth transplantation has been used in various indications to replace missing teeth. In this case series, we investigated the long-term outcomes following immediate tooth autotransplantation into fresh extraction sockets in young individuals in our center. A consecutive retrospective study was conducted on patients treated at the clinic of Oral and Plastic Maxillofacial Surgery at Ludwigshafen hospital in Germany. Demographic factors, indication for tooth autotransplantation, donor site, and recipient site were extracted from patient records. The clinical and radiographic outcomes of 11 autotransplanted teeth were evaluated in a follow-up observation period ranging from 20 to 78 months. A total of 11 tooth transplantations were carried out in nine patients during the study period. Chronic apical periodontitis, non-restorable extended caries, hypodontia, ectopical eruption and accidental trauma were the reasons for tooth transplantation. Overall, nine third molars, one second molar, and one canine were autotransplanted. Donor teeth were mandibular third molars in seven cases, maxillary third molars in two cases, a maxillary second molar in one case, and a maxillary canine in one case. Six donor teeth had completely formed roots and five had incompletely developed roots and an open apex at the time of surgery. After a mean follow-up of 44 months, 10 cases (90.9%) were successful; one case failed because of root resorption and uneventful bone remodeling. In four cases, external root resorption was observed. No pulp revascularization was observed during the recall period. The survival rate and success rate of tooth autotransplantation were 90.9% and 63.6%, respectively. Our results are in agreement with other published observations. We conclude that autologous tooth transplantation into fresh extraction sockets in young individuals has a high long-term success rate. Although the indications for autotransplantation are quite narrow, careful patient selection coupled with an appropriate surgical technique can lead to exceptional long-term functional results.