Tooth Autotransplantation using Surgical Guides and a Printed Donor Tooth Replica

• Published in: Journal of dentistry 2024-08, Vol.147, p.105181, Article 105181
• Main Authors: Babiuc, Iuliana, Diaconeasa, Marius, Malița, Mădălina Adriana, Burlibașa, Mihai
• Format: Article
• Language: English
• Subjects: 3D printing; surgical guide; tooth autotransplantation
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2024.105181

This case report describes the procedure of tooth autotransplantation using multiple surgical guides and a 3D printed replica of the donor tooth. The patient presented excessive crowding of the maxillary arch and edentulous mandibular space at the 46 position. Digital segmentation of the CBCT scan was performed to isolate the donor tooth, a maxillary premolar (25) with merged roots. The final position of the donor tooth was planned digitally. Two surgical guides were designed, following the direction of each root of the premolar. A replica of the donor tooth was 3D printed. A neoalveolus was prepared using the surgical guides, and additional drilling was necessary to correctly accommodate the donor tooth replica. Tooth 25 was extracted as atraumatically as possible. The resection of the apex was performed, followed by retrograde MTA root canal filling. The premolar was then positioned in the neoalveolus at the position of 46. Sutures were placed around the tooth, with no additional splinting. Endodontic treatment was performed after one month. The patient was monitored clinically and radiographically. The mobility of the tooth decreased progressively and was within normal limits after 3 months. Radiographic imagery showed the reorganization of the periodontal space, with a normal aspect at 10-month follow-up. Digital technology increases the predictability of the autotransplantation procedure by increasing the accuracy of the neoalveolus morphology, reducing the extraoral time of the donor tooth, and preventing possible cementum lesions that might lead to complications.