Clinical Scorecard: Cost Analysis of Tooth Autotransplantation for Pediatric and Young Adult Patients
At a Glance
Category
Detail
Condition
Missing permanent tooth in the maxillary central or lateral incisor region
Key Mechanisms
Uses a patient’s own tooth for replacement, permitting functional adaptation, alveolar bone growth, and formation of a functional periodontal ligament.
Target Population
Patients aged 8 through 25 years requiring single-tooth replacement in the maxillary anterior region
Care Setting
Not specified; the cost model uses national mean fees across all relevant dental care provider types.
Key Highlights
Previous research reports a 90% long-term survival rate for tooth autotransplantation (TA).
TA remains underused in the United States, partly because of limited awareness of its practical application and uncertainty about costs and reimbursement.
TA with limited orthodontics had mean procedural costs of $6,240 and mean time costs of $1,400.
When treatment options involving orthodontics were compared, TA with limited orthodontics had the lowest procedural and time-related costs.
The study compares TA with implant-supported prosthesis, resin-bonded fixed partial denture, and orthodontic space closure.
Guideline-Based Recommendations
Diagnosis
Evaluate patients with congenitally missing permanent teeth or early tooth loss caused by trauma or caries.
TA is typically first considered when potential donor teeth, such as premolars, reach the optimal developmental stage for transplantation.
Management
Consider TA as a viable and practical option for pediatric patients requiring maxillary anterior tooth replacement.
Discuss available treatment options and their associated costs with patients and families.
Monitoring & Follow-up
Monitor the transplanted tooth for positioning errors, inflammatory or apical resorption, and ankylosis.
The study’s clinical pathway includes postoperative assessment through 6 months.
Risks
Short-term complications may include positioning errors, inflammatory or apical resorption, ankylosis, and the possible need for extraction.
The cost model does not include expenses related to complications, repairs, replacements, insurance coverage, or long-term treatment.
Patient & Prescribing Data
The cost model applies to patients aged 8 through 25 years receiving a single-tooth replacement in the maxillary central or lateral incisor region. Maxillary or mandibular premolars were considered as donor teeth.
TA without orthodontic treatment was not evaluated because it is not recommended and is considered uncommon practice.
Clinical Best Practices
Present all treatment options together with their associated costs to support informed decision-making.
Do not use cost as the sole determinant in treatment planning.
Prioritize functional and esthetic stability, particularly for patients who are still growing.
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.
