Dental trauma occurs in approximately 20% of children and adolescents (Andersson, 2013). A significant number of dental trauma cases involve an injury to the central maxillary incisors (Glendor, 2008, Luo et al., 2020). The extent and pattern of tooth injury can vary but often result in tooth loss (Lambert et al., 2017). Managing the absence of anterior teeth in children presents a complex challenge due to their ongoing growth and development. Successful management necessitates the maintenance of alveolar bone growth in the affected, along with ensuring the effective restoration of both functionality and esthetics. In such cases, orthodontic space closure or prosthodontic restoration with implant placement after the completion of growth may be viable options. Otherwise, autotransplantation is recommended due to its high success rate, good esthetic outcomes, and patient satisfaction (Czochrowska et al., 2000, Plakwicz et al., 2023). Autotransplantation can be considered a permanent solution for growing children when performed successfully (Czochrowska et al., 2000, Czochrowska et al., 2002, Ong et al., 2016). Unlike implants, autotransplantation is available regardless of the patient’s growth status, and it preserves and stimulates alveolar bone growth (Plakwicz et al., 2016). Furthermore, autotransplantation allows for orthodontic movement of the transplanted tooth owing to the presence of a vital periodontal ligament (Park et al., 2010, Tanaka et al., 2008). This enables adaptation to the intraoral environment and facilitates natural eruption.

Autotransplantation is a technique that includes the extraction of a donor tooth and re-implantation of the donor tooth into a desired site within the same oral cavity (Ong et al., 2016). Children and adolescents aged 8- to 14-year-olds are believed to be an optimal group for autotransplantation (Ong et al., 2016). Selection is driven by various factors, including crown dimension, crown-root angle, and degree of root development. A previous morphometric study demonstrated that the mandibular first premolars are suitable candidates for the replacement of maxillary central incisors compared to the width and crown-root angle of the maxillary central incisors (Companioni et al., 2023). The teeth with incomplete root formation are recommended as donor teeth (Ong et al., 2016).

The anatomy of the recipient site is also important for favorable outcomes after autotransplantation. Sufficient alveolar housing at the recipient site is essential for the proper positioning of the donor tooth to ensure alveolar bone and periodontal tissue support (Hariri and Alzoubi, 2019, Tian et al., 2015). The donor tooth should be placed in close contact with the alveolar bone of the recipient site to ensure the supply of nutrients and blood (Andreasen et al., 1990, Park et al., 2012). It is advisable to have the alveolar housing dimensions exceed those of the donor tooth by 1 to 2 mm in both width and depth (Tsukiboshi, 2002). If sufficient alveolar housing is not expected in clinical situations, the recipient site should be surgically modified to match the donor tooth dimensions (Plotino et al., 2022). Ridge-split osteotomy can be applied in the case of a severe discrepancy between the recipient site and donor tooth dimensions (Ong et al., 2023). Transplantation with the rotation of the donor tooth may be also applied (Sasaki et al., 2022).

The above-mentioned issues suggest the need for anatomical evaluation of the anterior ridge profiles of children. Although studies on the alveolar ridge profiles of the anterior maxilla in adults are actively being conducted because of dental implants, studies on those in growing children are still limited. Therefore, this study aimed to assess the three-dimensional (3D) anterior ridge profiles of growing children according to age and sex and provide guidance for selecting autotransplantation in children.