Objective: To evaluate long-term successes and failures of autotransplanted premolars, followed up to 30 years.

Materials and methods: This study investigated a consecutive group of 100 patients treated with autotransplantation caused tooth aplasia and tooth loss. All patients (9.2–14.4 years, mean 12.8), 53 boys and 47 girls, had one-rooted premolars transplanted from one region to another. Totally 118 premolars were transplanted in root stages with an open apex wider than 1 mm. Primary healing and follow-up were tested using a Siemens electrometric pulp tester to detect pulpal reinnervation and standardized radiographs to test transplant healing and root development generally. Assessments were carried out at 1, 4, 8, 12 and 24 weeks and thereafter yearly after transplantation. Transplants were moved or rotated orthodontically 3–9 months after transplantation.

Results: Loss of teeth needed transplantation followed by orthodontic treatment. Most transplanted premolars showed normal tooth eruption, compared with contra laterals. Transplants induced tooth eruption and bone induction. Transplants erupted before visible root formation and before visible alveolar bone formation. Furthermore, marginal gingiva was transferred with both papillae. It was found successes of 93.1% and failures of 6.9% for all transplants. Premolars transplanted as maxillary incisors had a higher incidence of failures (15%) than premolars transplanted to the mandibular premolar regions (7.6%).

Conclusion: Marginal gingiva was transferred with both papillae. Transplants induced tooth eruption and alveolar bone induction. Transplantation induced tooth eruption and bone induction. Transplantation of one-rooted premolars carried out by a trained oral surgeon had a long-term success of 93.1%.

Conflict of interest: None.