Outcome of Autotransplantation of Mature Third Molars Using 3-dimensional-printed Guiding Templates and Donor Tooth Replicas

Abstract

Autotransplantation exhibits a number of advantages compared with other treatment options (ie, dental implants or fixed partial prostheses), such as greater resistance to occlusal loading, maintenance of the periodontal ligament and surrounding bone, and the potential for better esthetics. The aim of this study was to determine clinical outcomes for autotransplanted teeth with complete root formation using 3-dimensional-printed guiding templates and tooth replicas. Twenty-seven third molars with completely formed roots were autotransplanted. Each donor tooth and recipient site were examined clinically and radiographically (periapical radiographs). A selective cone-beam computed tomographic scan was taken of each donor tooth and recipient site. The images of the selected donor teeth were segmented and saved as stereolithography files. Similar to virtual planning of dental implants, correct angulation, rotation, and accurate positioning of the donor teeth were predefined using the stereolithography files. According to the virtually defined positions and dimensions of the donor teeth, 3-dimensional guiding templates and donor tooth replicas were printed. All autotransplantations were performed according to 1 treatment protocol and surgical technique. In 22 of the 24 transplanted teeth, no inflammation occurred during the healing period. At 2 years, no pathologic radiolucency or tooth resorption was observed in the 22 donor teeth. The autotransplanted teeth fulfilled the success criteria in 22 cases for a 91.7% success rate. Digital planning could potentially provide an accurate alternative to current autotransplantation techniques.

Keywords: 3-dimensional–printed guiding template; autotransplantation; digital planning; tooth replica.