Kaku Masato, Shimasue Hiroshi, Ohtani Junji, Kojima Shunichi, Sumi Hiromi, Shikata Hanaka, Kojima Shotoku, Motokawa Masahide, Abonti Tahsin Raquib, Kawata Toshitsugu, Tanne Kazuo, Tanimoto Kotaro
a Lecturer, Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Hiroshima, Japan.
Angle Orthod. 2015 May;85(3):518-24. doi: 10.2319/030314-148.1.
This case report describes the treatment of a skeletal Class III malocclusion with autotransplantation of a cryopreserved tooth. To gain an esthetic facial profile and good occlusion, extraction of bimaxillary premolars and surgical therapy were chosen. The patient had chronic apical periodontitis on the lower left first molar. Although she did not feel any pain in that region, the tooth was considered to have a poor prognosis. Therefore, we cryopreserved the extracted premolars to prepare for autotransplantation in the lower first molar area because the tooth would probably need to be removed in the future. The teeth were frozen by a programmed freezer with a magnetic field (CAS freezer) that was developed for tissue cryopreservation and were cryopreserved in -150°C deep freezer. After 1.5 years of presurgical orthodontic treatment, bilateral sagittal split ramus osteotomy was performed for mandible setback. Improvement of the facial profile and the occlusion were achieved in the retention phase. Six years after the initial visit, the patient had pain on the lower left first molar, and discharge of pus was observed, so we extracted the lower left first molar and autotransplanted the cryopreserved premolar. Three years later, healthy periodontium was observed at the autotransplanted tooth. This case report suggests that long-term cryopreservation of teeth by a CAS freezer is useful for later autotransplantation, and this can be a viable technique to replace missing teeth.
本病例报告描述了一例采用冷冻保存牙齿自体移植治疗骨性III类错牙合畸形的病例。为获得美观的面部轮廓和良好的咬合关系,选择拔除双侧前磨牙并进行手术治疗。患者左下第一磨牙患有慢性根尖周炎。尽管她在该区域没有感到任何疼痛,但该牙被认为预后较差。因此,我们冷冻保存了拔除的前磨牙,为将来在左下第一磨牙区域进行自体移植做准备,因为这颗牙齿可能在未来需要拔除。这些牙齿通过专门为组织冷冻保存开发的带有磁场的程序冷冻仪(CAS冷冻仪)进行冷冻,并保存在-150°C的深冻箱中。经过1.5年的术前正畸治疗后,进行了双侧矢状劈开下颌升支截骨术以后退下颌。在保持期实现了面部轮廓和咬合的改善。初诊6年后,患者左下第一磨牙出现疼痛,并观察到有脓液排出,因此我们拔除了左下第一磨牙,并将冷冻保存的前磨牙进行了自体移植。三年后,在自体移植牙处观察到牙周组织健康。本病例报告表明,使用CAS冷冻仪对牙齿进行长期冷冻保存有助于后期的自体移植,这可能是一种可行的替代缺失牙的技术。