Guided Auto-Transplantation of a Supernumerary Tooth Into a Surgically Created Socket Using Osseodensification and a Palatal Connective Tissue Graft: A Case Report

Abstract

This case report describes the replacement of a missing maxillary right central incisor (tooth number 8) with a supernumerary tooth using cone beam computed tomography based digital planning, a three-dimensional printed donor replica tooth, osseodensification, and connective tissue grafting. A 36-year-old male presented with general periodontitis and a healed socket in the number 8 region 3 months postavulsion. Based on cone beam computed tomography scans, auto-transplantation of a single-rooted mandibular supernumerary tooth into a surgically created socket in the number 8 region was planned. Root canal treatment was performed on the donor tooth prior to its extraction. Digital planning was performed, and a three-dimensional replica of the donor tooth was designed and printed. The surgically created socket was prepared with an osseodensification technique. Extraction of the donor tooth was performed atraumatically, and soft tissue grafting and splint stabilization was performed after its placement in the socket. A definitive crown was placed at 12 months. At 30 months the transplanted tooth was functional and asymptomatic, with no clinical or radiographic signs of apical pathosis.