Tooth autotransplantation: review suggests good survival but evidence limited


Protocols for the autotransplantation of teeth were established in the 1960s and while survival rates of 90% have been reported there are risks associated with the procedure.

The aim of this review was to assess the long-term survival rates of tooth autotransplantation.


Searches were conducted in the PubMed, Scopus, Web of Science, Lilacs, and The Cochrane Library databases. Controlled trials or prospective/retrospective studies reporting survival rate, pulp condition, mobility, presence of ankylosis, and root resorption of autotransplanted teeth with complete or incomplete root formation with a follow-up period of 6 years or greater were considered.

Two reviewers independently assessed studies for inclusion and abstracted data. Study quality was assessed using the Methodological Index for Non- Randomized Studies (MINORS).   Survival rate, abnormal mobility, pulp condition and root resorption were evaluated and meta-analysis carried out.


  • 5 studies reported in 6 papers involving 274 teeth were included
  • 5 studies were retrospective, 1 prospective
  • All 5 studies were considered to have a medium risk of bias
  • Survival rates (4 studies) ranged from 75.3% to 91% and with meta-analysis showing a mean survival rate of 81% (95%CI; 73.8 – 86.6%)
  • The percentage ankylosis (4 studies) ranged from 4.2% to 18.2% and with meta-analysis showing a mean ankylosis rate of 4.8% (95%CI; 2.3 – 9.8%)
  • Meta-analysis (3 studies) showed a mean resorption of 4% (95%CI; 1.8 – 8.5%)


The authors concluded

An excellent survival rate (81%), after a follow-up period of at least 6 years, was observed. Ankylosis (4%) and root resorption (4%) rates, despite their low values, influenced the prognosis of the autotransplanted teeth.


While a wide ranging search for relevant papers has been carried out only 5 small studies have been identified and all but one of the included studies are retrospective. The authors rightly identify this as a potential issue as there is an unknown level of attrition bias (drop out) in these studies. The authors also highlight the possibility of publication bias although with so few studies available the value in testing for this may be doubtful. Consequently while this review suggests an 81% survival rate at 6 years these findings should be viewed with caution until more higher quality prospective studies are available.


Primary paper

Machado LA, do Nascimento RR, Ferreira DM, Mattos CT, Vilella OV. Long-term prognosis of tooth autotransplantation: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2015 Dec 13. pii: S0901-5027(15)01423-X. doi: 10.1016/j.ijom.2015.11.010. [Epub ahead of print] Review. PubMed PMID: 26696138.

Other references

Dental Elf – 1st April 2015 – Intentionally replanted teeth: a possible treatment option?

Dental Elf – 29th April 2014 – Review suggests that autotransplantation of teeth with complete root formation have favourable outcomes


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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