(PR61) A Systematic Review of Autotransplantation Systematic Reviews

Abstract: Autotransplantation (AT) allows fast, inexpensive replacement of patients’ missing teeth using superfluous natural teeth, suitable for growing people unlike implants. Many systematic reviews (SRs) conclude that AT is favorable; however, AT is rarely utilized.

Purpose: to conduct a SR of published AT SRs to determine if their findings provide sufficient prognostic and outcomes data for clinical decision making. Defined searching conducted in Medline, Embase, and the Cochrane Library produced 38 titles and identified 10 SR papers, published 2014-2020. SRs were heterogeneous in purposes, methods, outcome metrics, and variables studied. SRs included 6-38 subsidiary papers. SRs generally identified average durations and/or ranges of follow-up times, not actual follow-up times in their evidence tables, most were short or had low minima. Only 1 SR reported 1, 5, and 10-year survival rates; only 2 SRs reported annual failure rates; these rates were lower than those in the other SRs that lacked calculation of true rates. Success rates varied substantially and were lower than survival rates; again based on pooled or average time periods, not actual time periods. SRs indicated that AT outcomes criteria varied. Meta-analyses addressed ankylosis, antibiotics, root resorption, infection, pulpal disease, pulp obliteration, tooth type, root development, hypermobility and orthodontics, but these generally lacked power and/or precision. Esthetics were rarely considered. SRs of AT showed that few teeth were lost within the generally limited and unclear durations of their included studies; but, long-term outcomes and the impact of complications on patients were largely unmeasured; current prognostic evidence is inadequate.