Use of 3D printed model as an aid in surgical removal of a rare occurrence of a compound odontome in the anterior mandible associated with impacted teeth

Abstract

The use of 3D printing in the medical field has been well documented, with significant developments in fabrication of tissues, organs, customized prosthetics, implants, and anatomical models as well as pharmaceutical research. Its use in dentistry, however has been limited mainly to maxillofacial surgery and reconstruction, orthognathic surgery and trauma. Compound odontomes are usually prevalent in the anterior maxilla, however, their occurrence in the anterior mandibular region is rare. This case report highlights the effective usage of 3D printing as an aid in the surgical removal of a compound odontome and impacted incisors in the mandibular anterior region. The surgery was carried out under general anesthesia. A full thickness muco-periosteal flap was reflected and the compound odontome along with the impacted incisors were removed. The defect was restored using a mixture of autogenous scrapes harvested from the chin, xenograft and platelet-rich fibrin. Wound closure was done using 4-0 vicryl. A CBCT scan taken 1 year later confirmed uneventful healing and complete bone regeneration of the surgical defect. Key words:3D printing, model, compound odontome, impacted, incisors.

Figure 1

a) Anterior view showing absence of 31 and 32. b) CBCT scan showing cystic involvement with relation to impacted 31, 32 and an odontome. c) CBCT scan showing the presence of impacted 31, 32 and an odontome. d) 3D printed model of the mandible. e) Pre-surgical measurements being made on the 3D printed model. f) Transfer of pre surgical measurements on to the surgical area.

Figure 2

a) Full thickness mucoperiosteal flap raised. b) Surgical exposure of the impacted teeth. c)Extraction site of 31. d) Extraction of 32. e) Extracted 32, 31 (crown and root) and odontome.

Figure 3

a) Socket containing odontome. b)Enucleation of cystic lesion. c) Extraction sockets after the re-moval of 31,32 and odontome. d) Extraction sites filled with autogenous scrapes, xenograft and PRF. e) Post-surgical sutures. f) CBCT scan taken 1 year post-operatively.