Autotransplantation with preoperative simulation using three-dimensional replica –Report of three cases and review of literature

Abstract

Purpose The aim of this study was to evaluate the clinical outcome of autotransplantation of a mature third molar to a fresh molar extraction socket using three-dimensional (3D) replicas and a preoperative simulation, which includeduse of preoperative cone-beam computed tomographicy(CBCT) planning and 3D replicas of donor teeth to prepare the artificial tooth sockets. Methods Three patients underwent autotransplantation using 3D replicas and preoperative simulation. Before the procedure, the direction and depth of the donor tooth were confirmed with a computer using replica data, then a simulation was performed using the replica and the research model as pseudo-autotransplantation surgery. The replica was manufactured using a 3D printing technique. The surgical procedure was based on guided autotransplantation surgery methods associated with Andreasen’s technique. Results Based on Chamberlin's criteria for successful transplantation, all three patients had good results. The average extraoral time of the donor tooth was shortened to an average 3.33 minutes when using a 3D replica. Additionally, we previously presented a report of a case without 3D replica autotransplantation with a time of 16 minutes. Conclusions The present approach enables planning and production of a 3D printed surgical template with use of the latest diagnostic methods and guided autotransplantation surgery techniques. Autotransplantation using a 3D replicas with preoperative simulation is an effective method that can reduce extraoral time as well as periodontal ligament damage to the donor tooth, and can reduce the rate of failure.