Guided tooth autotransplantation in edentulous areas post-orthodontic treatment

Objective Tooth autotransplantation with a complete root formation to replace one or more lost teeth is indicated as a cost-effective alternative to implants. The aim of this case report was to describe a successfully guided autotransplantation of a maxillary third molar with fully formed roots into a surgically created socket after orthodontic space opening. Clinical considerations A guided autotransplantation of the maxillary left third molar into the missing maxillary left first molar site was chosen. After virtually orientating donor tooth to confirm its optimum fit, it was deemed necessary to open 4 mm the mesiodistal space. Following the orthodontic movement, a 3-dimensional (3D)-guiding template and a milled surgical guide were manufactured to allow the donor tooth to be transplanted exactly in the planned position. The 2-year follow-up periapical radiograph showed a continuous periodontal space with no signs of apical periodontitis or root resorption. Conclusions Virtual planning and 3D-printed tooth replica combined with guided surgery can simplify the autotransplantation technique for both the clinician and the patient, particularly when the socket has been completely created during surgery. Clinical significance Virtual digital planning, which can accurately calculate the exact space to open orthodontically before an autotransplantation, could prove essential to enhancing the precision of 3D placement of the donor tooth in the recipient site.