Intentional Replantation of Permanent Teeth for Endodontic Indications: An Umbrella Review of Clinical Outcomes, Prognostic Factors and Evidence Quality

This umbrella review synthesized evidence on the outcomes and prognostic factors of intentional replantation and assessed the methodological quality and primary-study overlap of existing systematic reviews. Systematic reviews with or without meta-analysis evaluating intentional replantation in permanent teeth were included. Seven reviews met the eligibility criteria. Reported pooled survival ranged from 85.9% to 89.1%, while success or healing ranged from 77.23% to 80.2%; however, this consistency must be interpreted cautiously due to very high primary-study overlap across the reviews. Evidence for prognostic factors was inconsistent, with several commonly proposed procedural factors lacking significant associations in pooled analyses. Five reviews had critically low confidence, and one had low confidence according to AMSTAR 2. Intentional replantation can achieve favourable tooth-retention outcomes in selected permanent teeth; however, confidence in current estimates is limited by methodological weaknesses, predominantly observational primary evidence and substantial evidence overlap. Higher-quality prospective and comparative studies are required. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO): CRD420261453494.