A Novel Approach for Computer-Assisted Template-Guided Autotransplantation of Teeth With Custom 3D Designed/Printed Surgical Tooling. An Ex Vivo Proof of Concept

Purpose: The aim of this study was to introduce a novel method for accurate autotransplantation with computer-assisted guided templates and assembled custom-designed surgical tooling and to test the feasibility and accuracy of this method ex vivo. Materials and Methods: A partially edentulous human mandibular cadaver was scanned with a cone-beam computed tomography (CBCT) system and an intraoral scan system. The 3-dimensional (3D) data of this cadaver were imported into specialized software and used to analyze the region of the recipient site and the donor tooth was selected. Subsequently, congruent to the donor tooth, custom surgical tools and a surgical guided template were designed and 3D printed. The guided osteotomy was performed and the donor tooth was transplanted. To evaluate the planned position of the donor tooth in relation to the position of the transplanted donor tooth, the mandible with the transplanted donor tooth was rescanned with the CBCT system and software matching was applied to measure the accuracy of the procedure. Results: The angular deflection of the transplanted donor tooth in relation to the planned donor tooth position was 3.1 degrees. When comparing the 3D positions of the shoulder, therewas a deviation of 1.25 mm and an apical deviation of 0.89 mm. Conclusion: With the use of currently available technology, it is feasible to accurately plan and create in a virtual simulation a donor tooth position with congruent custom surgical tools and to transfer this to a clinical setting with 3D printing. However, further research on multiple levels is needed to explore this novel approach. (C) 2016 American Association of Oral and Maxillofacial Surgeons