A Novel Approach to Repositioning and Stabilization of a Luxated Tooth With Displacement Using a 3D Printed Guide

Abstract

The management of traumatic dental injury aims at functional and esthetic rehabilitation. After luxation injury, a displaced tooth must be replaced into its normal position as soon as possible. Incorrect tooth repositioning can cause discomfort to the patient and compromise the outcome. This report documents a novel digital technology–based approach for the management of teeth following luxation injury with displacement. A 25-year-old female reported 2 days after traumatic dental injury to her maxillary right central incisor tooth #8. After clinical and radiographic examination, a diagnosis of lateral luxation of tooth #8 was made. The preoperative high-resolution cone-beam computed tomography (CBCT) image data set confirmed palatal luxation of tooth #8 with fractured and displaced labial cortical plate. The CBCT data were imported into a medical image processing software program, and a segmentation tool was used to segment the fractured cortical plate, luxated tooth, and alveolar process. The socket is reconstructed by realigning fractured cortical bone over the alveolar process and repositioning the tooth in the virtual planning software. A three-dimensional (3D) guiding template was designed over the repositioned tooth and adjacent teeth and printed. This 3D printed guide was used for the repositioning of luxated tooth #8 and stabilizing it during the splinting procedure. This technique of using CBCT and 3D guide for repositioning is an objective, precise, and predictable approach. The 3D printed model of the dental arch after virtual tooth alignment can be used by the dentist to determine the exact splint length and contour before splinting.