Bauss O, Engelke W, Fenske C, Schilke R, Schwestka-Polly R
Department of Orthodontics, Hannover Medical School, Hannover, Germany.
Int J Oral Maxillofac Surg. 2004 Sep;33(6):558-63. doi: 10.1016/j.ijom.2003.10.008.
The aim of the present study was to assess the results after transplantation of 85 immature third molars. Recipient site conditions varied and different surgical techniques were used. The long-term results after preparation of a new alveolus, splitting osteotomy of the alveolar process or use of free bone autografts were compared with the results after transplantation into a fresh extraction site (control group). Transplantations into prepared sockets showed equal results to the control group (94% respectively). Transplantations in connection with free bone autografts (84%) or after splitting osteotomy of the alveolar process (63%) showed poorer success rates, the differences between the latter and the control group being statistically significant. A possible correlation to revascularization disturbances of the pulp due to an insufficiency of the recipient site or to postoperative infection is suspected. The results show that transplantation of immature third molars is a safe, useful procedure when appropriate conditions of the recipient site are present. Where the alveolus is atrophic, a splitting osteotomy should be performed only in exceptional cases and preference should be given to alternative methods such as primary bone augmentation or bone-regenerative procedures.
本研究的目的是评估85颗未成熟第三磨牙移植后的结果。受体部位情况各异,采用了不同的手术技术。将制备新牙槽、牙槽突劈开截骨术或使用游离自体骨移植后的长期结果与移植到新鲜拔牙位点后的结果(对照组)进行比较。移植到制备好的牙槽窝中的结果与对照组相当(分别为94%)。与游离自体骨移植相关的移植(84%)或牙槽突劈开截骨术后的移植(63%)成功率较低,后两者与对照组之间的差异具有统计学意义。怀疑这可能与受体部位供血不足导致牙髓血管再生障碍或术后感染有关。结果表明,当受体部位条件适宜时,未成熟第三磨牙移植是一种安全、有用的手术。在牙槽萎缩的情况下,仅在特殊情况下进行牙槽突劈开截骨术,应优先选择替代方法,如一期骨增量或骨再生手术。