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Main Instructor
Department / Institution Department of Orthodontics / Changhua Christian Hospital, Taiwan
Classification Case report
Objective」 The second premolars have the highest incidence of congenital absence, after the third molars. The problem resides not in the prevalence of congenitally missing premolars but in the selection of a treatment plan that will yield the best results over the long term. The common orthodontic treatment choice is space closure or keep for further prothesis evaluation. The alternative treatment choice in extraction case is autotransplantation. An Angle Class I girl with #15 congenital missing was treated with autotransplantation using fixed appliance. The treatment process will be discussed.
Case」 The present study reports a case of a 12 year old female patient who has Angle Class I malocclusion with #15 congenitally missing, #11 impaction with associated crowding of teeth. The treatment plans included: extraction of #11, 24, 35 & 45, and autotransplantation of # 35 to #15.
「Discussion」There are typically three treatment options when a permanent tooth is missing: 1. preserve the deciduous tooth; 2. replace the missing tooth and 3. orthodontically close the space. For replacement of the missing tooth, besides prosthesis, the other approach is tooth autotransplantation. The criteria for success depends on : 1. Healthy periodontal ligaments ; 2. Stage of root development; 3. Alveolar bone health; 4. Donor–recipient size match. We use the D2P software to transform CBCT image of #35. Then we printed out the donor tooth (#35) with 3D printer. The perfect donor–recipient size match made the surgical procedure more accurate and faster. The donor tooth stayed vital 3 months after autotransplantation. 
Conclusion」 It is pertinent for orthodontists to apply 3D printing technique in orthodontic treatment with autotransplantation case. For young patients with premolar missing, besides space closure, autotransplantation is the treatment of choice to restore the final occlusion. 
3D Printing Application in Orthodontic Practice- A Case with Autotransplantation