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Most traumatic dental injuries occur in the preteen males, with the maxillary central incisor being the most commonly avulsed tooth.^1,2 When an incisor is lost, its ability to induce growth of the surrounding alveolar bone and gingival tissues is also lost. Therefore, in the maxillary anterior region of a young and growing patient, it is advantageous to replace a missing tooth with a natural tooth that can continue the process of bone induction as the patient continues growing through their teen years. There are currently two techniques to achieve this:

1) Orthodontic substitution

2) Auto transplantation. The methodology and necessary considerations pertaining to autotransplantation are the subject of this publication, and pertinent literature suggests that:

1. a) Ideal donor teeth should be single-rooted, such as a mandibular premolar.
2. b) Donor teeth should be ideally harvested when there is 2/3 to ¾ root development.
3. c) Surgical technique to avoid damaging the periodontal ligament of the donor tooth is absolutely critical.
4. d) Newly autotransplanted teeth should be stabilized for 6-12 weeks with a light orthodontic wire allowing physiologic movement. If the aforementioned protocols are followed, then a success rate of 90% or more can be expected.