Template-Guided Autogenous Tooth Transplantation Using a CAD/CAM Dental Replica in a Complex Anatomical Scenario: A Case Report.

Background: Autogenous tooth transplantation is a valuable option for dental rehabilitation, particularly in young patients. Template-guided approaches, using 3D-printed replicas of donor teeth, have recently emerged as a method to increase precision and reduce extraoral time-two critical factors in maintaining periodontal ligament (PDL) vitality, which is essential to improve long-term outcomes. Methods: This report presents the case of a 12-year-old patient who underwent autotransplantation of tooth 18 to the site of tooth 75, which exhibited ankylosis. Patients exhibiting unfavorable root anatomy and morphology, systemic conditions, or completed root development were not considered for this technique. A patient-specific donor tooth replica was digitally designed and 3D-printed via CAD/CAM manufacturing to preoperatively shape the recipient site. The transplanted tooth 18 was then inserted with an extraoral time of less than one minute and subsequently stabilized using a flexible titanium trauma splint (TTS). Results: Longitudinal clinical and radiographic follow-up over 12 months confirmed favorable healing without signs of complications. Conclusions: This case illustrates the practical advantages of a fully digital, template-guided workflow in managing anatomically complex cases.