To evaluate the economic impact of tooth autotransplantation (TA) on families and compare its procedural and time costs with those of other tooth replacement options for patients aged 8 through 25 years.
Approach:
Cost Model Development: A multistep, iterative process integrating a comprehensive literature review with expert consensus was used to develop clinical pathways for maxillary anterior TA, implant-supported prosthesis, resin-bonded fixed partial denture, and orthodontic space closure.
Procedural Costs: Costs were calculated using 2024 Current Dental Terminology codes and national fee data from FAIR Health and the American Dental Association Survey of Dental Fees.
Time Costs: Time away from work was estimated using the number of visits, 2 to 3 hours per visit, and national hourly wage data from the US Bureau of Labor Statistics.
Key Findings:
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.
When orthodontic treatment was included, TA with limited orthodontics was the least costly option after procedural and time-related factors were considered.
Interpretation:
TA with limited or comprehensive orthodontics represents a viable economic alternative to implant-supported prosthesis, resin-bonded fixed partial denture with orthodontics, and orthodontic space closure for maxillary anterior tooth replacement in young patients.
Limitations:
Clinical pathways were developed by a selected expert panel and may not represent all practitioners or clinical scenarios.
Costs of complications, repairs, replacements, insurance coverage, and long-term treatment were not included.
Dental fees vary by location and practice type, and wage data were limited to private-sector employees.
Conclusion:
TA is a practical tooth replacement option that warrants greater consideration for pediatric patients requiring maxillary anterior tooth replacement. Treatment decisions should also prioritize long-term functional and esthetic stability, particularly in growing patients.
