Survival and Success of Autotransplantation Maxillary Canine with Closed Apex: Systematic Review

The frequency of canine retention varies between 0.9% and 2.2%. When surgical exposure and subsequent orthodontic realignment are difficult or impossible due to unfavorable impaction position of an impacted maxillary canine or when the patient refuses prolonged orthodontic treatment, autotransplantation becomes a valuable alternative. The aim of this systematic review was to determine the level of success of maxillary canine autotransplantation, long-term stability, and factors involved in the outcome of this therapy. A literature search for all data published with 10 years limitation and no restriction of language was conducted, using: PubMed, Scopus, Web of Science, Medline Complete (EBSCO) and Cochrane. Specific journals in the area were also consulted Inclusion and exclusion criteria were specified. A total of 5 studies were included in the present analysis. Of the 5 studies, 3 were retrospective and 2 were prospective. For outcomes, the results with reference to teeth, alveolar bone, periodontal tissues, and esthetic satisfaction were considered. The mean age of the participants ranged from 13 to 42.1 years old. Risk of bias was evaluated using the methodological index for nonrandomized studies-MINORS. The studies with a follow-up of more than 5 years presented a survival rate higher than 83% and the success rate was: 38%. Studies with a follow-up of less than 5 years, survival rate was closer to 100% for, with success rate higher than 68%. The overall success rate and survival were high, despite the methodologic limitations of the included studies. There is sufficient clinical experience to justify transalveolar transplantation of maxillary canines, with closed apices, as a legitimate treatment alternative considering the proper indication. Further study is needed of the prognostic factors that influence the success of autotransplantation with closed apex.