Isaacson R J, Strauss R A, Bridges-Poquis A, Peluso A R, Lindauer S J
Department of Orthodontics, Virginia Commonwealth University, Richmond, USA.
Angle Orthod. 2001 Oct;71(5):411-8. doi: 10.1043/0003-3219(2001)071<0411:MAACIU>2.0.CO;2.
When a dentist replants an avulsed tooth, the repair process sometimes results in the cementum of the root and the alveolar bone fusing together, with the replanted tooth becoming ankylosed. When this occurs, the usual process of tooth movement with bone deposition and bone resorption at the periodontium cannot function. If dental ankylosis occurs in the maxillary incisor of a growing child, the ankylosed tooth also cannot move vertically with the subsequent vertical growth of the alveolar process. This results in the ankylosed tooth leaving the plane of occlusion and often becoming esthetically objectionable. This report describes a 12-year-old female with a central incisor that was replanted 5 years earlier, became ankylosed, and left the occlusal plane following subsequent normal vertical growth of the alveolar process. When growth was judged near completion, the tooth was moved back to the occlusal plane using a combination of orthodontics, surgical block osteotomy, and distraction osteogenesis to reposition the tooth at the proper vertical position in the arch. This approach had the advantage of bringing both the incisal edge and the gingival margin of the clinical crown to the proper height in the arch relative to their antimeres. Previous treatment procedures for ankylosed teeth have often involved the extraction of the affected tooth. When this is done, a vertical defect in the alveolar process results that often requires additional bone surgery to reconstruct the vertical height of the alveolar process. If the tooth is then replaced, the replacement tooth must reach from the final occlusal plane to the deficient ridge. This results in an excessively long clinical crown with a gingival height that does not match the adjacent teeth.
当牙医再植脱位牙时，修复过程有时会导致牙根的牙骨质与牙槽骨融合在一起，使再植牙发生骨性粘连。当这种情况发生时，牙周膜处常见的伴有骨沉积和骨吸收的牙齿移动过程就无法发挥作用。如果正在生长发育的儿童上颌中切牙发生了骨性粘连，那么随着牙槽突随后的垂直生长，粘连的牙齿也无法垂直移动。这会导致粘连的牙齿脱离咬合平面，并且在美观上常常令人难以接受。本报告描述了一名12岁女性，其一颗中切牙在5年前进行了再植，之后发生了骨性粘连，并在牙槽突随后的正常垂直生长过程中离开了咬合平面。当判断生长接近完成时，通过正畸、手术阻挡截骨术和牵张成骨术相结合的方法，将该牙齿移回到咬合平面，以便将其重新定位到牙弓中合适的垂直位置。这种方法的优点是使临床牙冠的切缘和牙龈缘相对于对侧牙在牙弓中达到合适的高度。以往针对骨性粘连牙齿的治疗方法通常是拔除患牙。这样做会导致牙槽突出现垂直缺损，往往需要额外的骨手术来重建牙槽突的垂直高度。如果随后进行牙齿替换，替换牙必须从最终咬合平面延伸到缺损的牙槽嵴。这会导致临床牙冠过长，牙龈高度与相邻牙齿不匹配。
