What is the impact of autotransplantation on the long-term stability and patient satisfaction of impacted canines? A Systematic Review

Introduction

Autotransplantation is a surgical technique in which a tooth is repositioned after extraction. It is commonly used for impacted canines, which affect about 2% of the population and are more prevalent in females. These canines may remain embedded due to their late eruption. Treatment options include orthodontic appliances or autotransplantation, especially when canines are positioned too high or angled more than 45 degrees from the occlusal plane.

Aim

To review the literature regarding the effects of autotransplantation on patient satisfaction, aesthetic outcomes, and the long-term stability of autotransplantation.

Materials and Methods

This Systematic Review, registered with PROSPERO (CRD4202341), followed the PICO framework. Extensive searches were conducted in the Cochrane Library, PubMed, ScienceDirect, Scopus, VHL Regional Portal, and Web of Science, covering literature up to April 1, 2023.

Results

The review analyzed 11 studies involving the autotransplantation of 395 canine teeth, including two mandibular canines. Findings indicate higher success rates in younger patients, with a higher prevalence of transplantation in females (1 6 4) than males (1 0 5). The survival rate of transplanted canines was up to 67.9 % after 21 years, with some surviving up to 27.8 years. Success factors included young age, female gender, minimal extraoral time, proper root canal treatment, and effective post-operative care. Negative factors included ankylosis, root resorption, root fractures, infections, and periodontal issues. Complications included tooth darkening and the need for crowning. Patient satisfaction was rarely reported, with only three studies mentioning it and none addressing quality-of-life directly.

Conclusion

Canine autotransplantation is viable for selected patients when other treatments are insufficient. Despite various influencing factors, consensus guidelines for procedural decisions still need to be improved, and reports on patient satisfaction and quality-of-life impacts should be more frequent.