Guidelines for autotransplantation of developing premolars to the anterior maxilla

Abstract

Loss of a permanent maxillary central incisor in a young patient is a therapeutic challenge for dental professionals. Autotransplanted developing premolars replacing missing maxillary incisors provide predictable long-term results and assure bone preservation during growth. Moreover, they can be successfully transformed to the morphology of the missing incisors, which is very important since these teeth are placed centrally in the esthetic zone. Comprehensive interdisciplinary treatment planning is necessary, combining a thorough evaluation of the occlusion and the profile, existing indications for premolar removal, space conditions, and the optimal match between the donor tooth and the recipient site. Orthodontic space management before and after surgery is often needed to create favorable conditions for donor accommodation, and to establish both normal occlusion and a good esthetic result. Monitoring of pulpal and periodontal healing and root development after transplantation of developing premolars is mandatory during follow-up appointments.