Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review

Abstract

Introduction: Tooth autotransplantation is the repositioning of an erupted, partially erupted, or non-erupted autologous tooth from one site to another within the same individual. Several factors influence the success rate of the autotransplant, such as the stage of root development, the morphology of the tooth, the surgical procedure selected, the extraoral time, the shape of the recipient socket, the vascularity of the recipient bed, and the vitality of the cells of the periodontal ligament. The aim of this scoping review was to provide the most up-to-date information and data on the clinical principles of the third-molar autograft and thus provide clinical considerations for its success.

Materials and methods: This review was conducted based on PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). The research was conducted by searching for keywords in three databases-PubMed, Scopus and Google Scholar-by two independent reviewers following the PRISMA protocol, from which 599 records were identified.

Conclusions: Third-molar autotransplantation is a valid solution to replace missing teeth. The key to the success of this technique is the surgical procedure, which must be as atraumatic as possible to preserve the periodontal ligament of the tooth to be transplanted. The success rate is also linked to the stage of development of the root, with a worse prognosis in the case of a complete root.

Keywords: oral surgery; third molar; tooth autotransplantation.

Figure 1

Flow chart of the different phases of the review.

Figure 2

Flow chart of all surgical steps and procedures.

Figure 3

Stages of development of the root of a molar according to Moorrees CFA et al. (1963) [62]: (a). stage 1: roots developed to one-quarter of their length; (b). stage 2: roots developed to one-half of their length; (c). stage 3: roots developed to three-quarters of their length; (d). stage 4: roots developed along their entire length with open apices; (e). stage 5: root apices half closed by a wide periodontal ligament; (f). stage 6: roots with closed apices.