Autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Despite current scientific evidence indicating that autotransplantation has favourable long-term survival rates, autotransplantation is still not generally regarded as mainstream practice outside of Scandinavian countries.Successful autotransplantation can offer many advantages in a growing patient, including a normally functioning periodontium, proprioception and preservation of alveolar bone volume. In the event that the autotransplantation eventually fails, the bone and soft tissue conditions would still be likely to be favourable for subsequent implant treatment.This review article will identify and discuss the factors that influence case selection, the ideal timing for autotransplantation and the critical determinants for achieving a successful outcome. The limitations of the technique and alternative treatment options will be discussed. It is hoped that through greater awareness and recognition by the dental profession, autotransplantation will become another viable treatment option in the management of compromised teeth in patients with significant remaining growth potential. INTRODUCTIONAutotransplantation is a controlled, sterile avulsion and re-implantation of a tooth into a distant site in the same person.1 While simple in concept, autotransplantation is still a controversial treatment option, however, it has been suggested as the treatment of choice in selected cases. 2,3Proponents of autotransplantation emphasise its ability to maintain and permit Accepted ArticleThis article is protected by copyright. All rights reserved.continuation of alveolar bone growth. A successfully transplanted tooth erupts with growth and can also be moved orthodontically. If a transplant fails at a later stage, a well maintained ridge can be prepared for an implant when most appropriate. For a successful outcome, preservation of the periodontal ligament of the transplanted tooth is the key to successful autotransplantation through prevention of ankylosis. An appreciation and respect for the biology of the periodontal ligament and the pulp is essential when considering this procedure. The critics of autotransplantation point to the lack of quality research and the dependence of the technique on surgical skill. HISTORICAL BACKGROUNDTooth autotransplantation began as allotransplantation, which is between two different people. Historical documentations date back to 1594 through the works of surgeon Ambroise Paré where royal families had teeth transplanted. In 1772, a surgeon, John Hunter successfully transplanted a tooth from one person to another. At this time there was no consideration or knowledge of disease transmission and immune compatibility. Later work focused on autografts, which are now termed autotransplantation.The technique of autotransplantation has existed for several centuries, however, the first clinical case reports appeared in the dental literature during the 1...

Tooth autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Autotransplantation can provide a long-term, cost-effective and biological solution for adolescent patients with congenitally missing teeth or significantly compromised teeth when a suitable donor tooth is available. Successful autotransplantation of immature teeth can offer many advantages for a growing patient, including a normally functioning periodontium, proprioception and preservation of alveolar bone volume. Even in the event that an autotransplanted tooth does eventually fail, the bone and soft tissue conditions are likely to be conducive for subsequent implant treatment. Despite the significant physiological and cost-benefit advantages, tooth autotransplantation remains relatively underutilized, as the procedure is considered to be technique-sensitive. Although carefully considered individual case selection and surgical skill are the critical determinants for success, advances in three-dimensional computed tomography and rapid prototyping have the potential to simultaneously reduce the technique sensitivity and increase the predictability of the autotransplantation procedure. It is hoped that this case series will provide greater awareness and an appreciation of the tremendous value of autotransplantation for the management of patients with congenitally missing or significantly compromised posterior teeth.

Significant dental trauma may result in short-term and long-term clinical dilemmas. There are many factors to consider when formulating the relevant and reasonable treatment options for such patients. Interdisciplinary management has the potential to significantly improve both aesthetic and functional outcomes in challenging cases. With respect to each presented option, the patient must be informed of the inherent advantages and disadvantages, the appropriate treatment timing, duration and the costs involved, both financial and biological.