Impact of root canal treatment timing on the prognosis of autotransplanted teeth with complete root formation: a systematic review and meta-analysis

This systematic review evaluated the influence of root canal treatment (RCT) timing on the prognosis of autotransplanted teeth with complete root formation. A systematic review was conducted according to the PRISMA guidelines. This study estimated survival rate, success rate, and root resorption rate of the teeth overall and across three RCT timings: postoperative prophylactic, intraoperative immediate, and clinical observation-based. Subgroup analyses were performed to investigate the influence of tooth type on outcomes. A total of 24 studies were included, involving 1473 autotransplanted teeth. The overall survival rate was 95% (95% confidence interval [CI]: 91%–97%), the success rate was 92% (95% CI: 80%–97%), and the root resorption rate was 16% (95% CI: 8%–30%). No statistically significant differences were observed in the survival rate and success rate among the postoperative prophylactic RCT group, intraoperative immediate RCT group, and clinical observation-based RCT group (all P > 0.05). However, the postoperative prophylactic RCT group exhibited the lowest root resorption rate (11%, 95% CI: 6%–18%). Current evidence indicates that different timings of RCT exert no significant impact on the overall prognosis of autotransplanted teeth with complete root formation. Nevertheless, postoperative prophylactic RCT may confer potential advantages in reducing the risk of root resorption. Due to the limitations of the non-randomized study design and heterogeneity of the included literature, this conclusion warrants verification by more high-quality studies. By systematically clarifying the prognostic differences and temporal evolution patterns associated with different RCT timings, this study provides exploratory observations and reference directions for the field of mature tooth autotransplantation, which is conducive to promoting the standardized application of this technique.