Gonzalez-Ocasio Jorge, Stevens Mark
Chief Resident, Department of Oral and Maxillofacial Surgery, Augusta University Medical Center, Augusta, GA.
Department Chair and Professor, Department of Oral and Maxillofacial Surgery, Augusta University Medical Center, Augusta, GA.
J Oral Maxillofac Surg. 2017 Sep;75(9):1833.e1-1833.e6. doi: 10.1016/j.joms.2017.04.018. Epub 2017 Apr 25.
The aim of this study was to examine the use of platelet-rich plasma (PRP) for autotransplantation of third molars as a successful technique to provide immediate tooth structure for space maintenance and masticatory function when premature loss of a permanent tooth occurs and other dental restorative options are not indicated.
This study included 10 healthy patients 10 to 17 years of age with at least 1 immature third molar (one to two thirds of root formation) used to replace extracted non-restorable teeth. Eleven third molars were transplanted and adapted to sockets of the extracted teeth with the adjunct of PRP. Transplanted teeth were stabilized to the adjacent teeth using orthodontic wires and dental composite for 1 month. Patients were followed for 1 year. Function, tooth vitality, root development, and periodontal health were recorded.
All 10 patients had functioning asymptomatic transplanted teeth, with physiologic tooth mobility after splint removal at 1 month and after 1 year. All 10 patients had positive tooth vitality (by cold test) at 3, 6, and 12 months; all transplants showed positive root development (average growth, 2.01 mm) confirmed and measured using periapical radiographs. No patients required root canal therapy at any point in the study. Periodontal assessments were performed at the scheduled follow-up appointments with circumferential periodontal probing. Periodontal health was maintained because probing depths were shallower than 4 mm during the 1-year follow-up.
Autotransplantation of immature third molars with PRP shows excellent results and should be considered a viable option for premature loss of permanent molars. PRP might have other advantages, such as root promotion and neurosensory development.
本研究的目的是检验富血小板血浆(PRP)用于第三磨牙自体移植的效果,当恒牙过早缺失且其他牙齿修复方法不适用时,该技术可作为一种成功的方法,为间隙保持和咀嚼功能提供即时的牙齿结构。
本研究纳入10名10至17岁的健康患者,他们至少有1颗未成熟的第三磨牙(牙根形成一至三分之二),用于替代拔除的无法修复的牙齿。11颗第三磨牙被移植,并在PRP辅助下适配到拔除牙齿的牙槽窝。使用正畸钢丝和牙科复合材料将移植牙与相邻牙齿固定1个月。对患者进行1年的随访。记录功能、牙齿活力、牙根发育和牙周健康情况。
所有10名患者的移植牙功能正常且无症状,在1个月和1年后拆除夹板时牙齿有生理性松动。所有10名患者在3个月、6个月和12个月时牙齿活力均为阳性(冷测试);所有移植牙均显示牙根发育阳性(平均生长2.01毫米),通过根尖片确认并测量。在研究的任何阶段,均无患者需要根管治疗。在预定的随访预约中进行牙周评估,采用圆周牙周探诊。在1年的随访期间,牙周健康得以维持,因为探诊深度小于4毫米。
使用PRP进行未成熟第三磨牙的自体移植显示出优异的效果,应被视为恒牙过早缺失的一种可行选择。PRP可能还有其他优势,如促进牙根生长和神经感觉发育。