Allogenic tooth transplantation using 3D printing: A case report and review of the literature

Abstract

Background: The history of allogenic tooth transplantation can be traced back to the 16^th century. Although there have been many successful cases, much needs to be better understood and researched prior to the technique being translated to everyday clinical practice.

Case summary: In the present report, we describe a case of allogenic tooth transplantation between a mother and her daughter. The first left maxillary molar of the mother was diagnosed with residual root resorption and needed to be extracted. The 3^rd molar of the daughter was used as a donor tooth. Prior to transplantation, a 3D printing system was introduced to fabricate an individualized reamer drill specifically designed utilizing the donor's tooth as a template. The specific design of our 3D printed bur allowed for the recipient site to better match the donor tooth. With the ability to 3D print in layers, even the protuberance of the root can be matched and 3D printed, thereby minimizing unnecessary bone loss.

Conclusion: Our study is a pioneering case combining 3D printing with allogenic tooth transplantation, which could be able to minimize unnecessary bone loss and improve the implant stability. This article aims to enhance our understanding of allogenic tooth transplantation and 3D printing, and may potentially lead to tooth transplantation being utilized more frequently - especially since transplantations are so commonly utilized in many other fields of medicine with high success rates.

Keywords: 3D printing; Allografts; Case report; Dental implants; Transplantation.

Figure 1

Preoperative photos and computed tomography scan of the donor and the recipient. A and B: Occlusal photos showing the recipient’s missing #26; C and D: Occlusal photos showing the donor’s #48; E: The recipient’s orthopantomogram taken before the surgery; F: Computed tomography image showing the cross section of the bone at #26.

Figure 2

Individual drill compared with donor’s tooth. A: The 3D image of the donor’s tooth was extracted from the cone beam computed tomography, a computer-aided design model was built using measuring instrument to gather information for the shape and size, and an individual drill was manufactured by direct metal laser sintering; B: The cross section comparison of the individual drill and the donor’s tooth; C and E: The model of the drill in the recipient’s alveolar bone; D and F: The model of the donor’s tooth in the recipient’s alveolar bone.

Figure 3

Surgical procedure. A: The donor’s tooth was extracted, then the attached gingival was gently removed, but the periodontal ligament was kept; B: Treatment with solutions of 10 g/L cephalosporin, 75 g/L clindamycin hydrochloride, and 50 g/L aspirin in sequence; C: Soft tissue reflection; D: Expanding the pilot hole by using progressively wider drills; E: Finishing the preparation by using the individual drill; F: Collecting the autogenous bone during the hole preparation; G and H: Applying the autogenous bone to fill the compartment; I and J: Transplanting the tooth to the recipient’s site; K: Suture; L: Splinting the tooth with an acid-etch resin composite splint.

Figure 4

Periapical radiographs of the transplanted tooth after surgery. A: One day after transplantation; B: One week after transplantation; C: One month after transplantation, inflammatory resorption and replacement resorption were progressing; D: Two months after transplantation; E: Three months after transplantation; F: Four months after transplantation, inflammatory resorption and replacement resorption were stable, and there was no appearance of normal periodontal ligament up to this time; G and H: Photos showing the transplanted tooth four months after surgery.