Criteria and prognostic factors for survival and success rates for autotransplantation in the area of first and second molars: a systematic review and meta-analysis

Autotransplantation of immature third molars is an effective treatment option, offering high success rates, minimal complications, and notable improvements in occlusal function and dental aesthetics. This study aims to review and evaluate the available evidence specifically on the survival and success rates of immature autotransplanted third molars and to identify prognostic factors that influence these outcomes. A comprehensive search was conducted in the Elsevier Journals (ScienceDirect), MEDLINE (PubMed), and Dentistry & Oral Sciences Source (EBSCOhost) databases up to May 2024. Risk of bias within studies was asse ssed with the CASP guidelines. Nine studies met the inclusion criteria for qualitative and quantitative analysis. The pooled survival rate was consistently high across studies, estimated at 91.867% (95% CI: 85.058% to 96.741%), while the success rate, though slightly lower, remained substantial at 90.162% (95% CI: 79.813% to 97.067%). Key prognostic factors identified include the developmental stage of the donor teeth (Moorrees stages from R ¼  to Rc), showing enhanced success due to better potential for pulp revascularization and continued root growth. Additionally, innovative techniques, including advanced methods like computer-aided rapid prototyping (CARP) and platelet-rich plasma (PRP), were found to positively impact healing and integration. Fixation methods also played a role, as excessive rigid fixation was linked to higher rates of ankylosis and inflammatory root resorption. Future research should prioritize recipient site and donor tooth characteristics, standardized success criteria, extended follow-up periods, and refined treatment protocols to enhance predictability and long-term outcomes in teeth autotransplantation.