Prevalence of Post‐Operative Complications in Autotransplanted Teeth: A Long‐Term Retrospective Cohort

BACKGROUND/AIMS: To evaluate the prevalence and timing of post-operative complications following tooth autotransplantation, identify factors associated with earlier diagnosis, and report long-term survival and success rates. MATERIALS AND METHODS: A single-centre retrospective cohort study was conducted at a Czech university dental clinic (2003-2024); no external funding. Donor teeth were grouped as premolars, molars and anterior (canines, incisors, one premaxillary supernumerary; predominantly single-rooted, single-canal). Root development was classified according to Moorrees: early (1-3), optimal (4-5), late (6-7). Survival/success were estimated with Kaplan-Meier; timing of first diagnosis with event-only cumulative incidence (1-Kaplan-Meier); and factors associated with earlier occurrence with Cox proportional hazards regression. RESULTS: The study included 134 teeth in 111 patients (74 premolars, 48 molars, 12 anterior). Half of the complications were diagnosed within 18 months (median time to first diagnosis: 11.7 months inflammatory resorption, 19.6 months apical pathology, 18.0 months cervical resorption, 21.4 months replacement resorption). Five-year survival: premolars 95.4%; molars 86.6%; anterior 75.8%. Five-year success: 75.3%, 76.8% and 66.0%, respectively. Age ≥ 30 years was associated with earlier tooth loss and apical pathology; male gender with earlier inflammatory resorption and loss of success. Anterior teeth and restorative indications (e.g., caries, previous root canal treatment failure) were associated with earlier apical pathology. A single preoperative dose of amoxicillin 1 g ~1 h before surgery or a 7-day post-operative amoxicillin course (500-1000 mg) was associated with delayed diagnosis of infection-related complications. Some treated complications recurred or transformed into another type, requiring additional intervention. CONCLUSIONS: Early detection enables successful management of most complications. As half occurred within 18 months-the critical window-follow-up should include reviews at 1 week, 1 month, 3 months and every 3 months until 2 years post-transplantation, with continued long-term monitoring for recurrences and late complications.