The use of biologic adjuncts in tooth autotransplantation: a scoping review

Abstract

PURPOSE: To summarize the available clinical evidence on biological adjuncts in tooth autotransplantation, including adjunct types, application protocols, procedural variables, reported outcomes, and evidence gaps. METHODS: This scoping review followed JBI guidance and PRISMA-ScR. PubMed/MEDLINE, Embase, Web of Science, Scopus, and LILACS were searched from inception to 21 June 2026. Clinical human studies reporting tooth autotransplantation with at least one biologic adjunct and clinical or radiographic outcomes were included. Data were charted for study characteristics, population, autotransplanted teeth, adjunct type and application protocol, follow-up, and key findings. Critical appraisal was performed using design-specific tools. RESULTS: Twenty-two sources published between 2005 and 2026 were included, comprising 234 patients and 257 autotransplanted teeth. Most evidence came from case reports and case series, with few comparative clinical studies. Platelet-derived preparations were the most frequently reported adjuncts, including L-PRF, A-PRF, PRP, PRGF, and CGF. Enamel matrix derivative was also reported, mainly as a root-surface application. Most studies described favorable clinical and radiographic outcomes, but protocols, root maturity, recipient-site conditions, stabilization, endodontic strategies, follow-up schedules, and outcome definitions were highly heterogeneous. Comparative and retrospective studies had serious risk of bias, mainly due to confounding. CONCLUSION: Biological adjuncts in tooth autotransplantation have demonstrated clinical feasibility in selected reports, but current evidence is insufficient to establish their independent benefit or superiority over standard protocols. Root maturity and procedural variables appear to be more consistent determinants of outcomes and should guide interpretation.