Premolar Autotransplantation to the Anterior Maxilla Region-Aesthetic Outcome and Patient Satisfaction

The aim of this study was to assess the aesthetic results and patient satisfaction of premolars transplanted to the maxillary incisor region.

In this multicenter study, 192 patients were included, with a minimum follow-up of 3 years. The aesthetic evaluation comprised two parts: Assessment of the PES/WES score using standardized intraoral photographs. Patient's perspective (VAS questionnaire).

The mean PES score was 6.94 (range, 2-10), and the mean WES score was 7.44 (range, 2-10). Most patients' aesthetic results were clinically acceptable (64.6%) to nearly perfect (9.4%). Significant correlations were found between PES and the orientation of the transplant at the receptor site (p = 0.038) and the level of oral hygiene (p < 0.001). A rotated orientation of the transplanted premolar at the receptor site and a poor/moderate level of oral hygiene are associated with lower PES scores. For the WES, there was a significant correlation with the restorative dentist (p < 0.001); if the restorative dentist was based at Center A instead of Center B, this is associated with higher WES scores. The response rate for the VAS questionnaire was 61.9%. 84.8% of the patients perceived the aesthetic outcome of the transplanted premolar the same as other teeth, 15.9% were not satisfied with the restorative treatment, and 12.6% were not satisfied with the surrounding tissues.

Autotransplantation is a viable treatment option in cases with missing upper front teeth; PES/WES scores were at least comparable but mostly higher than those found in implant studies evaluating single-tooth replacement in the anterior maxilla. The VAS questionnaire showed that patients were satisfied with their transplanted tooth, which was consistent with the results of previous studies.

The aesthetic outcomes of premolars transplanted to the maxillary incisor region are predominantly favorable.