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

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

Material and methods: 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).

Results: 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.

Discussion: 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.

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