{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:01:29Z","timestamp":1760058089683,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T00:00:00Z","timestamp":1742083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Tooth autotransplantation is a well-established dental surgical procedure. However, third molar autotransplantation to bony free flaps is rarely performed. We present a case of two impacted wisdom teeth that were transplanted to a DCIA free flap using 3D printing technologies. Case report: A 10-year-old girl was diagnosed with ossifying fibroma. She underwent a segmental mandibular resection with nerve preservation and reconstruction using a DCIA free flap. Six years later, due to edentulism, wisdom tooth autotransplantation was performed with digital planning, thermoplastic vacuum-formed guides, and 3D-printed replicas. Postoperatively, splint fixation was required for 12 weeks due to mobility, and a minor wound complication resolved spontaneously. At the one-year follow-up, the transplanted teeth integrated successfully without resorption or ankylosis. Orthodontic treatment was initiated to optimize alignment. Conclusions: This case of an impacted third molar autotransplantation to a DCIA free flap in an adolescent patient after a non-malignant mandibular tumor resection and reconstruction demonstrates promising results. The application of 3D printing technology significantly enhances the feasibility of dental transplantation in challenging cases, particularly for suboptimal donor teeth such as impacted wisdom teeth, by enabling precise surgical planning and optimized recipient site preparation while also reducing damage to the grafted teeth during transplantation. Further research is needed to assess the role of tooth autotransplantation in bony free flaps.<\/jats:p>","DOI":"10.3390\/children12030370","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:49:57Z","timestamp":1742197797000},"page":"370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Autotransplantation of Impacted Third Molars to DCIA Free Flap in Adolescent Patient: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"given":"Benjamin","family":"Walch","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Gaggl","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2569-6898","authenticated-orcid":false,"given":"Katharina","family":"Zeman-Kuhnert","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3296-0060","authenticated-orcid":false,"given":"Christian","family":"Brandtner","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jaber, M., Prasad, P., Akeil, M., Moufti, A., Al-Sammarraie, A., and Charaf Eddin, C. (2024). Long-Term Evaluation of Tooth Transplantation: An Umbrella Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113341"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"cjad067","DOI":"10.1093\/ejo\/cjad067","article-title":"Prognostic factors, outcomes, and complications for dental autotransplantation: An umbrella review","volume":"46","author":"Cremona","year":"2024","journal-title":"Eur. J. Orthod."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Singh, A.K., Khanal, N., Acharya, N., Hasan, M.R., and Saito, T. (2022). What Are the Complications, Success and Survival Rates for Autotransplanted Teeth? An Overview of Systematic Reviews and Metanalyses. Healthcare, 10.","DOI":"10.3390\/healthcare10050835"},{"key":"ref_4","first-page":"e66904","article-title":"From Concept to Clinical Practice: A Review of Autotransplantation Techniques and Their Impact on Dentistry","volume":"16","author":"Ajay","year":"2024","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.gien.2018.05.003","article-title":"Tooth autotransplantation. What\u2019s the limit of our possibilities in conservative treatments?","volume":"32","author":"Milani","year":"2018","journal-title":"G. Ital. Endod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.3233\/THC-220581","article-title":"Dental implants in growing patients: A systematic review and meta-analysis","volume":"31","author":"Elagib","year":"2023","journal-title":"Technol. Health Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"69","DOI":"10.17796\/1053-4625-43.2.1","article-title":"Adverse Effects of Implants in Children and Adolescents: A Systematic Review","volume":"43","author":"Kamatham","year":"2019","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.bjoms.2019.04.011","article-title":"Dental implants in growing patients: A systematic review","volume":"57","author":"Bohner","year":"2019","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Park, S., Lee, H., Lee, E., Jeong, T., Lee, H., and Shin, J. (2023). Guided Autotransplantation of Impacted Canines Using a CAD\/CAM Surgical Template. Children, 10.","DOI":"10.3390\/children10040708"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Han, S., Wang, H., Chen, J., Zhao, J., and Zhong, H. (2022). Application effect of computer-aided design combined with three-dimensional printing technology in autologous tooth transplantation: A retrospective cohort study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-021-02030-z"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101842","DOI":"10.1016\/j.jebdp.2023.101842","article-title":"Outcomes of Autotransplanted Third Molars with Complete Root Formation: A Systemic Review and Meta-Analysis","volume":"23","author":"Huang","year":"2023","journal-title":"J. Evid. Based Dent. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Dioguardi, M., Quarta, C., Sovereto, D., Troiano, G., Melillo, M., Di Cosola, M., Cazzolla, A.P., Laino, L., and Lo Muzio, L. (2021). Autotransplantation of the Third Molar: A Therapeutic Alternative to the Rehabilitation of a Missing Tooth: A Scoping Review. Bioengineering, 8.","DOI":"10.3390\/bioengineering8090120"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0901-5027(98)80006-4","article-title":"Autotransplantation of premolars. A retrospective study","volume":"27","author":"Frenken","year":"1998","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/S0278-2391(98)90416-5","article-title":"Tooth autotransplantation into the bone-grafted alveolar cleft: Report of two cases with histologic findings","volume":"56","author":"Hamamoto","year":"1998","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Testori, T., Simion, M., Car\u00f9, F.G., Corbella, S., Taschieri, S., Perrotti, G., Cocconi, R., Calatrava, J., Decker, A., and Wang, H.L. (2024). Immature Tooth Autotransplantation with Buccal Bone Fenestration Treated with GBR and Immature Tooth Autotransplantation in Regenerated Bone: Proof of Principles with Medium- (55 Months) to Long-Term (252 Months) Follow-ups. Int. J. Periodontics Restor. Dent., 1\u201322.","DOI":"10.11607\/prd.7356"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wu, Y., Chen, J., Xie, F., Liu, H., Niu, G., and Zhou, L. (2019). Autotransplantation of mature impacted tooth to a fresh molar socket using a 3D replica and guided bone regeneration: Two years retrospective case series. BMC Oral Health, 19.","DOI":"10.1186\/s12903-019-0945-8"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.ijom.2021.04.010","article-title":"Pre-autotransplantation alveolar process augmentation and premolar autotransplantation as a treatment method for single tooth replacement in adolescents","volume":"50","author":"Verweij","year":"2021","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/SCS.0b013e31818436ef","article-title":"Tooth autotransplantation in a free iliac crest graft for prosthetic reconstruction","volume":"19","author":"Landes","year":"2008","journal-title":"J. Craniofac Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103371","DOI":"10.1016\/j.jdent.2020.103371","article-title":"Long term survival of mature autotransplanted teeth: A retrospective single center analysis","volume":"98","author":"Boschini","year":"2020","journal-title":"J. Dent."},{"key":"ref_20","first-page":"e30491","article-title":"Tooth Autotransplantation as an Alternative Biological Treatment: A Literature Review","volume":"14","author":"Kakde","year":"2022","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.adaj.2024.01.006","article-title":"Advancements in tooth autotransplantation","volume":"155","author":"Dokova","year":"2024","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1038\/s41415-020-1264-9","article-title":"Autotransplantation of third molars: A literature review and preliminary protocols","volume":"228","author":"Armstrong","year":"2020","journal-title":"Br. Dent. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1093\/ejo\/cjs112","article-title":"Importance of root development in autotransplantations: A retrospective study of 137 teeth with a follow-up period varying from 1 week to 14 years","volume":"35","author":"Denys","year":"2013","journal-title":"Eur. J. Orthod."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lucas-Taul\u00e9, E., Bofarull-Ball\u00fas, A., Llaquet, M., Mercade, M., Hern\u00e1ndez-Alfaro, F., and Gargallo-Albiol, J. (2022). Does Root Development Status Affect the Outcome of Tooth Autotransplantation? A Systematic Review and Meta-Analysis. Materials, 15.","DOI":"10.3390\/ma15093379"},{"key":"ref_25","first-page":"e241","article-title":"New complementary alternatives in third molar autotransplantation: A systematic review","volume":"29","author":"Niklander","year":"2024","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_26","first-page":"5512804","article-title":"Long-Term Outcome of Autotransplantation of a Complete Root Formed a Mandibular Third Molar","volume":"2021","author":"Kimura","year":"2021","journal-title":"Case Rep. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/iej.13974","article-title":"Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline","volume":"56","author":"Duncan","year":"2023","journal-title":"Int. Endod. J."},{"key":"ref_28","first-page":"59","article-title":"Novel non-obturation based concept of regeneration: Apical debris extrusion","volume":"38","author":"Teja","year":"2024","journal-title":"G. Ital. Endod."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/370\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:31Z","timestamp":1760028871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,16]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["children12030370"],"URL":"https:\/\/doi.org\/10.3390\/children12030370","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,3,16]]}}}