Accuracy of CAD-CAM Surgically Guided Tooth Autotransplantation Using Guided Templates and Custom-designed Osteotomes in Human Cadaver Mandibles

尸体 自体移植 截骨术 口腔正畸科 医学 锥束ct 牙科 材料科学 移植 解剖 外科 计算机断层摄影术
作者
Francesc Abella,Marc García‐Font,Venkateshbabu Nagendrababu,P. M. H. Dummer,Fernando Durán‐Sindreu,Andrea Rosales,Juan Gonzalo Olivieri
出处
期刊:Journal of Endodontics [Elsevier]
卷期号:49 (8): 1035-1043
标识
DOI:10.1016/j.joen.2023.06.008
摘要

A major challenge in dentistry is the replacement of teeth lost prematurely due to trauma, caries, or malformations; especially in growing patients. The aim of this study was to assess the accuracy of CAD-CAM surgically guided tooth autotransplantation in cryopreserved cadaver mandibles using guided templates and custom-designed osteotomes.Cryopreserved human cadaver heads were digitized and scanned using an intraoral optical scanner and a large-volume cone beam computed tomography device. First, virtual surgical planning was performed to create a 3D tooth replica, 2 surgical guides, and a custom-made osteotome for each single-rooted tooth autotransplantation procedure/case. Surgical sockets were created in the selected mandibles using guided tooling consisting of an initial guided osteotomy with implant burs and a final guided osteotomy using custom osteotomes. After tooth autotransplantation, second large-volume cone beam computed tomography images of the 5 cadaver mandibles were obtained. The discrepancy in mm within the 3D space (apical and mesiodistal deviations) between the final position of the autotransplanted teeth and their digitally planned 3D initial position was calculated and analyzed statistically (P < .05).All donor teeth were placed without incident within their newly created sockets in the real mandibles. The mean difference between the digitally planned root apex position and the final tooth position was 2.46 ± 1.25 mm. The mesiodistal deviation of the autotransplanted teeth was 1.63 ± 0.96 mm.The autotransplantation of single-rooted teeth with custom-designed and 3D-printed surgical tooling provided promising results. The technique was able to create surgically prepared sockets that could accommodate transplanted teeth in mandibles.
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