Success Rate of Autotransplantation of Teeth With an Open Apex: Systematic Review and Meta-Analysis

Purpose: The aim of the present study was to determine the success rate of autotransplanted permanent teeth with an open apex and to identify the most influential prognostic factors. Materials and Methods: A systematic search of the MEDLINE, EMBASE, LILACS, and SciELO databases was conducted for January 1990 to August 2015. The study eligibility criteria were primary studies that had evaluated patients with autotransplantation with an open apex, with or without preparation of the socket, and a minimum of 12 months of follow-up. The principal outcome was the success rate of autotransplanted teeth with an open apex. Two of us independently performed the selection process and data extraction. The Effective Public Health Practice Project's Quality Assessment Tool was used for the quality assessment of the studies. The odds ratio (OR) was calculated, with the 95% confidence interval (CI). Results: A total of 21 studies were included in the present analysis. Of the 21 studies, 10 were retrospective and 11 were prospective. All the studies were of weak methodologic quality. The overall success rate was 89.68%, the survival rate was 98.21%, and the mean follow-up period was 6 years, 3 months (standard deviation 5.81 years). Among the prognostic factors analyzed, the premolars had a lower failure risk than did the molars (OR, 0.46; 95% CI, 0.25 to 0.84). The stage of development of the root and the autotransplantation receptor site showed no statistically significant differences. Conclusions: The overall success rate and survival were high, despite the methodologic limitations of the included studies. Further study is needed of the prognostic factors that influence the success of autotransplantation with an open apex. (C) 2016 American Association of Oral and Maxillofacial Surgeons