Outcomes of dental autotransplantation in relation to dental root formation. Systematic review and meta-analysis.

INTRODUCTION: Dental autotransplantation (DAT) is a surgical procedure used to replace hopeless or missing teeth. The technique entails the purposeful extraction of a desired sound tooth, which is then implanted into another alveolar site of the same oral cavity. OBJECTIVES: To analyse the survival rates and success rates of DAT in relation to donor teeth with an incomplete root development (open apex) and complete root formation (closed apex). Additionally, it attempts to evaluate the prognostic components of DAT with infection-related (inflammatory) root resorption, ankylosis, and pulpal necrosis complications. MATERIALS AND METHODS: An electronic search was conducted using EBSCO MEDLINE Web of Science, Scopus and Cochrane databases from January 2014 until November 2024. The selected articles were chosen within the parameters outlined in the Materials and Statistical Methodology section. The addressed PICO question "does the stage of the donor tooth's root development affect the long-standing prognosis and clinical outcomes of dental autotransplantation?". RESULTS: The final 26 articles featured a total of 2837 transplanted teeth: 2192 donor teeth with an open apex and 645 donor teeth with a closed apex. The overall survival rate was 93.8% in the open apex group and 92.6% in the closed apex group. Success rate was 84.0% in the open apex group and 86.7% in the closed apex group. The rate of infection-related root resorption was 6.3% in the open apex group and 5.9% in the closed apex group. The rate of ankylosis was 4.4% in the open apex group and 6.7% in the closed apex group. The rate of pulp necrosis was 6.4% in the open apex group. No factors were identified as influencing the rate of pulp necrosis; however, the duration of follow-up was significantly associated with the rate (p = 0.057). None of the selected articles reported pulp necrosis rate in the closed apex; thus, no meta-analysis was possible. CONCLUSION: DAT is a reliable treatment alternative for the replacement of lost teeth. The procedure yields low complication rates of infection-related root resorption, ankylosis, and pulp necrosis, while achieving high rates of survival and success. It can be accomplished with donor teeth that have an open or closed apex.