Management of missing maxillary anterior teeth with emphasis on autotransplantation.

Over 40 years ago, Slagsvold and Bjercke developed a method of transplanting teeth with partly formed roots. After transplantation, root growth continues, and the teeth maintain their capacity for functional adaptation. Endodontic treatment is usually not necessary. The 3 main indications for autotransplantation of developing premolars are unevenly distributed multiple agenesis, agenesis of the mandibular second premolars in low-angle face types with normal or weak facial profiles, and accidentally lost or congenitally missing maxillary central and lateral incisors. Most traumatic injuries with accidental loss of maxillary incisors occur in children between 7 and 10 years of age. This makes autotransplantation of developing premolars an interesting treatment alternative. The optimal time for autotransplantation of premolars to the maxillary anterior region is when the root development has reached two thirds to three fourths of the final root length. The prognosis for complete periodontal healing at this stage of root development is better than 90%. Next to timing, the most important factors are the skill and experience of the surgeon