Identifying important prognostic factors and outcomes for autotransplantation of developing teeth: Clinicians' perspectives

Abstract

Background/Aim: Variability in the outcome measures used to assess the success of tooth autotransplantation presents challenges for combining data to examine the success of the technique. Reaching agreement on the most important outcomes will enable routine procedural and follow-up data to be collected in a standardised way. In turn this will promote greater data synthesis to evaluate outcomes and examine which procedural techniques influence outcome. The aim of this study was to identify which prognostic factors and outcomes are most important to clinicians with experience in autotransplantation of developing teeth. Methods:The Delphi method was used to build consensus on the most important prognostic factors and outcomes. Item identification involved a systematic literature review and review of current clinical datasets in use. A two-round Delphi questionnaire was undertaken with clinicians providing tooth autotransplantation, followed by a consensus meeting to finalise the most important items.Results: Outcomes and prognostic factors were identified from the systematic review (82 studies and eight reviews), one guideline and three existing clinical datasets.Patient interviews and a clinician survey added a number of items that would not have been identified from the literature only. A total of 56 outcomes and 93 prognostic factors were included for rating in the Delphi questionnaire. The Delphi questionnaire was completed by 15 respondents in round one and 13 respondents in round two.The consensus meeting was attended by nine participants. The final items that were judged to be most important included 29 outcomes (25 clinical, three patient-reported and one service delivery) and 49 prognostic factors (18 patient characteristics, four presurgical, 17 surgical and 10 postsurgical). Clinical outcomes were consistently rated higher than patient-reported outcomes. Conclusions:The clinical outcomes rated as the most important were transplant survival and reason for failure, outcomes relating to pulp health, different types of resorption and evidence of infection (suppuration). Important patient-reported outcomes were | 31 BARBER et al.

Improving data quality from routine clinical appointments—Development of a minimum dataset for traumatic dental injuries in children and adolescents

“…The issue of multiple outcomes being deemed important or of critical importance has occurred in other similar projects. 48 Ultimately, the consensus meeting proved more valuable in terms of reaching con- when the MDS-TDI is under review, the importance of responding to post-meeting questionnaires will be emphasised.…”

Editorial

“…Not only does this special issue offer an up-to-date review and synthesis of the evidence supporting the use of tooth autotransplantation, 4,5 it also offers a consensus-led autotransplantation core outcome set, 6 and an index for reporting the success of this technique which will help streamline future research in this field. 5 In addition, this special issue presents the results of original research assessing the long-term outcomes of 144 anterior and 1654 posterior transplanted teeth, 7,8 and the use of new technologies to improve the outcome of autotransplantation.…”