Gault Philippe
Orthod Fr. 2013 Sep;84(3):221-40. doi: 10.1051/orthodfr/2013058. Epub 2013 Sep 3.
Techniques for dental transplantation today are taking better advantage of the potential for healing of the periodontal ligament than in the past and have reduced the risk of ankylosis and root resorption to below 1.5%. The resulting improvement in prognosis has made it possible to more confidently plan procedures that include orthodontic treatment. Transplantations can offer a good end result in certain clinical situations that would otherwise be difficult to manage: ectopic teeth, transpositions, tooth trauma sequellae, advanced decay or advanced periodontitis, implanted hard to treat impacted teeth, and idiopathic ankylosis. This article describes the biological principles for transplantation using double periodontal ligament stimulation, explains the surgical techniques and provides several examples to expand on the treatment of impacted canines, whether or not they present with idiopathic ankylosis. Dental ankylosis is the fusion of the bone with the root. The idiopathic type occurs spontaneously before the eruption of the affected tooth. The etiology is unknown. Because the tooth becomes part of the process of osseous remodeling, it is progressively resorbed and then replaced by bony tissue. This process takes place rather quickly and weakens the tooth. Additionally, an early diagnosis makes it possible to plan a transplantation under favorable circumstances, as that is the only way to halt the ankylosis and to achieve an adequate implantation. In rare cases, the location of the ankylosis is surgically accessible and can be eliminated before resuming orthodontic traction.
如今的牙移植技术比过去更好地利用了牙周膜的愈合潜力,并将骨粘连和牙根吸收的风险降低到了1.5%以下。预后的改善使得更有信心地规划包括正畸治疗在内的手术成为可能。在某些难以处理的临床情况中,移植可以带来良好的最终效果:异位牙、牙换位、牙外伤后遗症、严重龋齿或严重牙周炎、植入难以治疗的阻生牙以及特发性骨粘连。本文描述了使用双重牙周膜刺激进行移植的生物学原理,解释了手术技术,并提供了几个例子以详细说明阻生尖牙的治疗,无论其是否伴有特发性骨粘连。牙骨粘连是骨与牙根的融合。特发性类型在患牙萌出前自发发生。病因不明。由于牙齿成为骨重塑过程的一部分,它会逐渐被吸收,然后被骨组织替代。这个过程发生得相当快,会使牙齿变弱。此外,早期诊断使得在有利的情况下规划移植成为可能,因为这是阻止骨粘连并实现充分植入的唯一方法。在极少数情况下,骨粘连的位置可以通过手术到达,并在恢复正畸牵引之前消除。