If you've lost a tooth and have a healthy wisdom tooth or extra premolar, you may not need a synthetic implant. Tooth autotransplantation moves a healthy tooth from its current location into the gap — giving you back a real tooth with a natural periodontal ligament and the ability to grow with the jaw (critical for adolescents). At AQUA, Dr. Mohamed Assaggaf leads the surgical phase with Dr. Obadah Austah (endodontic phase) and Dr. Mohanad Atwa (final restoration) — using a CBCT-driven protocol with a 3D-printed replica of the donor tooth.
The ideal case combines three criteria. The donor tooth: a wisdom tooth or extra premolar with two-thirds to three-quarters root development (a partially open apex = highest success rate), intact periodontal ligament, and no canal calcification. The recipient site: adequate alveolar bone width and height to accommodate the donor root, healthy gingiva, and proper vertical clearance. The patient: good oral hygiene, non-smoker, not on IV bisphosphonates or recent jaw radiation. The most common scenario: an adolescent who lost a front tooth in trauma and has a healthy wisdom tooth available.
We begin with a 3D CBCT scan of both the donor tooth and the recipient site, then 3D-print a plastic replica of the donor (Verweij technique). On surgery day: we prepare the recipient socket using the printed replica BEFORE extracting the actual donor — this reduces the tooth's out-of-mouth time to under 60 seconds, which is the single most important factor in preserving the periodontal ligament. We atraumatically extract the donor, place it in the new site at a slight sub-occlusal position, and apply a semi-rigid splint for 7–14 days. Endodontic follow-up at 4–6 weeks; final restoration at 6–12 months.
Tooth autotransplantation isn't a single procedure — it's a sequence across three specialties. Dr. Mohamed Assaggaf leads the surgical phase — he's the first author of a 2025 study in the Healthcare journal on Saudi dentists' awareness of this technique. Dr. Obadah Austah handles the endodontic phase: when the donor has a closed apex (mature root), we perform prophylactic root canal therapy at week 2–4 to prevent pulp necrosis — a delicate decision requiring specialist endodontist judgment. Dr. Mohanad Atwa completes the prosthetic phase: zirconia crown or veneer depending on the case. This three-specialty integration under one roof is what raises success rates from 80% to 95%+.
We will frankly decline this procedure in these situations: untreated severe periodontitis, active smoking (3× higher failure rate), IV bisphosphonate or denosumab therapy (osteonecrosis risk), recent head and neck radiation, no suitable donor tooth available, inadequate alveolar bone at the recipient site, or genetic syndromes affecting bone healing. In these cases we recommend a synthetic implant or alternative prosthetic options — and being upfront about alternatives is part of our protocol.
Long-term research (Andreasen and 10-year follow-ups) shows: open-apex donor (adolescent): 97.3% 5-year survival, 96.6% 10-year. Closed-apex donor with prophylactic root canal: 80–90% 5-year. Full timeline: surgery in one day, splint removal at 7–14 days, endodontic check at week 4–6, initial bone healing at 3 months, prosthetic rehabilitation eligible at 6–12 months. The transplanted tooth retains sensation and the ability to grow with the jaw — two advantages no synthetic implant can offer.
The cost of tooth autotransplantation varies case-by-case because it combines three phases (surgery, prophylactic root canal if needed, final restoration) and depends on donor tooth complexity and recipient site condition. Your initial evaluation visit includes a CBCT scan and a fully transparent three-phase quote before any decision. Contact us to book your initial evaluation for an accurate quote for your case.