Work

A novel full digital workflow for dental autotransplantation: surgical accuracy and clinical outcomes in a prospective cohort study

Year: 2026

Type: article

Abstract: Introduction: Dental autotransplantation is a biologically conservative alternative to prosthetic or implant-supported rehabilitation, though achieving predictable outcomes remains challenging. The use of digital workflows integrating CBCT-based planning, 3D modelling, and customized surgical guides may improve surgical precision and reproducibility. This study aimed to evaluate the accuracy and clinical outcomes of a full-digital workflow for dental autotransplantation. Methods: Patients with a non-restorable tooth and a healthy third molar suitable for donation were included. Preoperative CBCT and intraoral scans were used to enable automatic segmentation, virtual simulation of donor tooth positioning, and planning of alveolar site preparation. Customized, root-based surgical guides were then designed and 3D-printed. The surgical procedure included extraction of the non-restorable tooth, harvesting of the donor third molar, and its transplantation into the prepared alveolar site. The accuracy of the surgical protocol was assessed by superimposing postoperative CBCT-derived 3D models onto the preoperative plan using digital qualitative and quantitative analyses. Clinical outcomes, including tooth stability, periodontal health, and periapical status, were evaluated over an 18-month follow-up period. Results: Ten patients (6 males, 4 females; mean age 27.2 ± 2.77 years) were enrolled. Mean surface deviations between planned and post-operative models were 0.63 ± 0.45 mm (tooth) and 0.17 ± 0.06 mm (alveolar bone). Three-dimensional linear discrepancies averaged 2.04 ± 1.24 mm at the coronal level and 1.36 ± 1.00 mm apically. Angular deviations showed no systematic rotational bias, with limited pitch and roll deviations and higher interindividual variability for yaw. Two teeth required post-surgery endodontic treatment. All transplanted teeth showed clinical stability, physiological probing depths, and absence of pathological mobility. Conclusions: At 18 months, a fully digital workflow with customized surgical guides enabled accurate and minimally invasive dental autotransplantation, reducing extra-alveolar time and preserving the vitality of the periodontal ligament.

Source: Frontiers in Oral Health

DOI: 10.3389/froh.2026.1786907