(TC63) Autotransplantation of an Impacted Immature 3 Rd Molar Using a 3D Printed Model and A Tooth Replica

Abstract: Early loss of first molars represents a dilemma, particularly when the patient is between the ages of 15 and 20 years old. Orthodontic movement of the 2nd molar following its eruption can also be challenging. Placement of a dental implant is contraindicated at this age. While autotransplantation can be an option, it is technically complex as the third molar is not fully erupted and may have little to no root formation to provide primary stability. In this table clinic, we present an autotransplantation of an impacted, immature 3rd molar into the position of a non-restorable maxillary first molar in a 16-year-old male patient. Prior to the procedure, a tooth replica of the impacted 3rd molar was 3D printed and used to check the adaptability of the donor tooth into the extraction site on a 3D printed model. Following the surgical extraction of the 1st molar, the 3D replica was inserted into the site to check its adaptability in the patient’s mouth. Once confirmed, a mucoperiosteal flap was raised to extract the 3rd molar and immediately insert it into the donor site with under 1 minute of extra-oral time. The tooth was then flexibly splinted in place. Short-term follow-up showed complete tooth stability and soft and hard tissue remodeling. The approach presented herein can serve as an alternative to lengthy and more cost-effective treatment options while maintaining proprioception and allowing for pulp regeneration of a third molar that would otherwise be extracted at a later stage.