Enhanced socket preparation during autotransplantation: a new treatment protocol

Area of Science:

• Dentistry
• Oral Surgery
• Biomedical Engineering

Background:

• Tooth autotransplantation (AT) is a recognized method for replacing missing or unrestorable teeth.
• Cone-beam computed tomography (CBCT) scans enable the creation of 3D models for surgical planning.
• Previous methods for AT have aimed to optimize donor tooth handling and recipient site preparation.

Observation:

• A 13-year-old patient with hypodontia underwent AT of a mandibular second premolar into the site of a congenitally missing maxillary canine.
• A titanium 3D model of the donor tooth was fabricated using direct metal laser 3D printing from CBCT data.
• The 3D model was used as a guide to prepare the recipient socket with trephine burs, ensuring a precise fit.

Findings:

• The titanium replica facilitated accurate recipient site preparation, minimizing donor tooth extraoral time to just 4 minutes.
• The AT procedure resulted in a successful outcome, confirmed by follow-up examinations up to 1 year post-surgery.
• This technique demonstrates the efficacy of 3D-printed models in enhancing AT predictability and efficiency.

Implications:

• This innovative approach using 3D replicas can improve the success rates of tooth autotransplantation.
• The precise socket preparation minimizes trauma to the donor tooth, potentially leading to better root development and vitality.
• This technique offers a valuable advancement in dental reconstructive surgery, particularly for complex cases of tooth agenesis or loss.