Cost Analysis of Tooth Autotransplantation for Pediatric and Young Adult Patients
Overview
Tooth autotransplantation (TA) is an option for replacing missing teeth in pediatric and young adult patients. This study develops a cost model for maxillary anterior TA and compares its procedural and time costs with those of implant-supported prosthesis, resin-bonded fixed partial denture, and orthodontic space closure.
Background
Managing missing permanent teeth in children and adolescents can be challenging because of continuing growth and the limitations of conventional restorative options. TA uses a patient’s own tooth and permits functional adaptation, alveolar bone growth, formation of a functional periodontal ligament, and physiological or orthodontic tooth movement.
Data Highlights
TA with limited orthodontics had mean procedural costs of $6,240 and mean time costs of $1,400.
TA with comprehensive orthodontics had mean procedural costs of $10,461 and mean time costs of $2,974.
Implant-supported prosthesis with comprehensive orthodontics had the highest mean costs: $15,279 in procedural costs and $3,324 in time costs.
Resin-bonded fixed partial denture without orthodontics had the lowest mean costs: $4,455 in procedural costs and $437 in time costs.
The modeled number of visits ranged from 5 for resin-bonded fixed partial denture without orthodontics to 38 for implant-supported prosthesis with comprehensive orthodontics.
Key Findings
Previous research reports a 90% long-term survival rate for TA.
TA with limited or comprehensive orthodontics was a viable economic option compared with implant-supported prosthesis, resin-bonded fixed partial denture with orthodontics, and orthodontic space closure.
When treatment options involving orthodontics were compared, TA with limited orthodontics had the lowest procedural and time-related costs.
TA remains underused in the United States, partly because of limited awareness of its practical application and uncertainty about costs and reimbursement.
Clinical Implications
Dental care professionals should consider TA for pediatric patients requiring maxillary anterior tooth replacement. Treatment planning should pair available options with their associated costs while also prioritizing functional and esthetic stability, particularly in patients who are still growing.
Conclusion
TA represents a viable and practical option for maxillary anterior tooth replacement in pediatric patients. Additional research is needed to evaluate long-term costs, complications, repairs, replacements, broader clinical scenarios, and the effects of insurance coverage.
Related Resources & Content
“A Tooth Autotransplantation Cost Model for Pediatric Through Young Adult Patients” — Caitlin Miller, DMD, MS; Jessica Lee, DDS, MPH, PhD; Glenn Reside, DMD, MS; Antonio Moretti, DDS, MS; Gustavo Oliveira, DDS, MS; Dick Barendregt, DDS, PhD; and John Christensen, DDS, MS — JADA — 2026.
“Outcome of Tooth Transplantation: Survival and Success Rates 17–41 Years Posttreatment” — Czochrowska EM, Stenvik A, Bjercke B, and Zachrisson BU — Am J Orthod Dentofac Orthop — 2002.
“Survival and Success Rates of Autotransplanted Premolars: A Prospective Study of the Protocol for Developing Teeth” — Plakwicz P, Wojtowicz A, and Czochrowska EM — Am J Orthod Dentofac Orthop — 2013.
“Agenesis of Maxillary Lateral Incisor and Tooth Replacement: Cost-Effectiveness of Different Treatment Alternatives” — Antonarakis G, Prevezanos P, Gavric J, and Christou P — Int J Prosthod — 2014.
“Tooth Autotransplantation as an Alternative Biological Treatment: A Literature Review” — Kakde K and Rajanikanth K — Cureus — 2022.
“A Cost Analysis of Orthodontic Space Closure and Implant Treatment in Patients Missing Maxillary Lateral Incisors With a Long-Term Perspective” — Hedmo C, Lindsten R, Josefsson E, and Davidson T — Eur J Orthod — 2023.
“A Systematic Review of the Survival of Teeth Intentionally Replanted With a Modern Technique and Cost-Effectiveness Compared With Single-Tooth Implants” — Mainkar A — J Endod — 2017.
“Implants Versus Short-Span Fixed Bridges: Survival, Complications, Patients’ Benefits: A Systematic Review on Economic Aspects” — Scheuber S, Hicklin S, and Brägger U — Clin Oral Implants Res — 2012.
“Evaluating the Health Economic Implications and Cost-Effectiveness of Dental Implants: A Literature Review” — Vogel R, Smith-Palmer J, and Valentine W — Int J Oral Maxillofac Implants — 2013.
