Enhanced socket preparation during auto transplantation: A new treatment protocol.

Tooth autotransplantation (AT) is a viable option for the replacement of unrestorable or missing teeth. Recently, the use of a 3D replica of a donor tooth constructed from cone-beam computed tomography scans was described. The model is made to assess the recipient site's size and minimize the required extraoral time of the donor tooth after extraction. The aim of the paper is to describe a new technique for AT using the 3D replica as a socket preparation tool. A 13-year-old male who presented with hypodontia was referred for consultation and treatment. The treatment plan included combined Orthodontic treatment and AT of the left mandibular second premolar into the site of congenitally missing maxillary right canine. A titanium 3D model of the donor tooth was printed by a direct metal laser 3D printer utilizing the model from the CBCT scan. An intrasulcular flap was elevated, and the edentulous maxillary ridge was prepared using implant trephine burs with increasing diameters. A surgical mallet was utilized to apply vertical forces to the 3D-printed model, which was inserted into the prepared socket to allow a perfect fit for the donor tooth. After atraumatic extraction of the mandibular second left premolar, the donor tooth was inserted into the ready socket and splinted. Follow-up examinations 1, 3, 6 months and a year after surgery demonstrated a successful outcome. The titanium replica was successfully used for precise preparation of the recipient site, minimizing the extra-oral time of the procedure to four minutes. Therefore, improving the expected outcome.