Departamento de Medicina Dentária, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
Med Oral Patol Oral Cir Bucal. 2011 Nov 1;16(7):e984-9. doi: 10.4317/medoral.16926.
The aim of this study was to assess the pulp survival that occur in transplants of autologous teeth, by comparing two surgical techniques: the conventional technique (autotransplantation for newly formed alveoli), and an alternative technique, (autotransplants for alveoli in the initial phase of healing). In each surgical techniques were applied, randomly, either saline solution or Emdogain®.
The study group comprised 26 patents, in which 28 teeth were transplanted to recipient sockets prepared mechanically. Of the 28 teeth transplanted, 4 were intentional replants, and of the remainer, 11 had the apex closed and 13 open. The mean age at the time of transplantation was 22.34 ± 8.14 years (mean ± SD). The transplantation were performed by the same operator, with the informed consent of the patient and authorized by the ethical committee of the hospital. Clinical and radiological examinations were performed during 24 to 65 months (48 ± 12.96; MED ± SD), from 10 days, 1 month, 3 months, 6 months and annually to 5.6 years.
Only two transplanted teeth were lost, due persistent apical periodontitis, and one transplanted patient with open apex missed the treatment. In the teeth with pulp, we needed to perform root canal therapy in 9. In the 73% of the teeth with closed apex, we needed to perform root canal treatment, with no statistically significant difference found among closed apex and root canal therapy (p=0.083). In only 8% of the teeth with open apex did we need to perform root canal treatment, with an association between open apex and root canal therapy (p=0.0002). The overall success rate was 98% with significant difference for losses (p=0.0001).
Although not a frequent procedure, it was concluded that autotransplanted teeth, performed with appropriate surgical care had a good prognosis, and can render a very useful service to the patients.
本研究旨在评估自体牙移植中发生的牙髓存活情况，通过比较两种手术技术：传统技术（新形成牙槽的自体移植）和替代技术（愈合初始阶段的牙槽的自体移植）。在每种手术技术中，随机应用生理盐水或 Emdogain®。
研究组包括 26 名患者，其中 28 颗牙齿被移植到机械制备的受体牙槽中。在移植的 28 颗牙齿中，有 4 颗是故意再植的，其余的 11 颗根尖封闭，13 颗根尖开放。移植时的平均年龄为 22.34 ± 8.14 岁（均值 ± 标准差）。移植由同一位医生进行，患者知情同意，并获得医院伦理委员会的授权。在 24 至 65 个月（48 ± 12.96；MED ± 标准差）的时间内进行了临床和放射学检查，从 10 天、1 个月、3 个月、6 个月和每年到 5.6 年。
只有两颗移植牙因持续性根尖周炎而丢失，一名根尖开放的移植患者未接受治疗而失访。在有牙髓的牙齿中，我们需要进行根管治疗的有 9 颗。在 73%的根尖封闭的牙齿中，我们需要进行根管治疗，但根尖封闭和根管治疗之间无统计学差异（p=0.083）。在仅 8%的根尖开放的牙齿中，我们需要进行根管治疗，根尖开放与根管治疗之间存在关联（p=0.0002）。总体成功率为 98%，失牙率差异有统计学意义（p=0.0001）。
尽管不是一种常见的手术，但自体移植牙在适当的手术护理下，预后良好，可以为患者提供非常有用的服务。
