Esthetic Outcomes Following Tooth Autotransplantation: A Cross- Sectional Comparison with Site-Matched Pristine Teeth

To evaluate clinician-rated esthetic outcomes of autotransplanted teeth versus site-matched ideal pristine teeth using the pink and white esthetic scores (PES/WES), and to identify factors associated with esthetic ratings.

Patients who had received tooth autotransplantation with a minimum follow-up of 1 year, and control subjects who underwent a comprehensive clinical evaluation, were rated for PES/WES by six blinded evaluators (three oral surgeons, three general practitioners) using standardized digital imaging.

The study comprised 74 teeth in 40 participants: 37 autotransplanted teeth in 33 patients (mean age 24.5 years; mean follow-up 8.5 years) and 37 site-matched pristine teeth in 7 volunteers (mean age 29.1 years). Autotransplanted teeth scored significantly lower than pristine teeth on PES (11.4 vs. 12.9) and WES (7.4 vs. 9.5, both p≤0.001). The largest item-level differences concerned tooth volume, form, color, and soft tissue color, texture, and contour. Oral surgeons consistently rated higher than general practitioners (p≤0.002). Recipient jaw, treatment success, and presence of a coronal restoration were associated with esthetic ratings (p≤0.03).

Tooth autotransplantation achieves favorable long-term clinician-rated esthetic outcomes, albeit consistently below those of ideal pristine teeth. Esthetic outcomes were associated with site- and treatment-related factors, restorative management, and clinician background.