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影响儿童和青少年牙齿自体移植成功的结果及预后因素。

Outcomes and prognostic factors that influence the success of tooth autotransplantation in children and adolescents.

作者信息

Kafourou Vasiliki, Tong Huei Jinn, Day Peter, Houghton Nadine, Spencer R James, Duggal Monty

机构信息

Private practice, Athens, Greece.

Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore.

出版信息

Dent Traumatol. 2017 Oct;33(5):393-399. doi: 10.1111/edt.12353. Epub 2017 Jul 14.

Abstract

BACKGROUND/AIM: Tooth autotransplantation has been advocated for replacement of missing teeth or teeth that are unsuitable for restoration. The aim of this study was to investigate the outcomes and prognostic factors that influenced the success of tooth transplantation in a paediatric population.

MATERIALS AND METHODS

Data were extracted from the records of 75 patients (89 teeth). Demographic and prognostic factors were recorded and analysed for the clinical and radiographic outcomes for periodontal ligament (PDL) and pulp healing of transplanted teeth.

RESULTS

The mean age at transplant was 13.2 years, and the mean follow-up observation period was 2.6±1.8 years with a range of 12.0 months to 9.9 years. The main reason for transplantation was to replace upper central incisors lost or missing due to dental trauma, hypodontia and dilaceration. Of the 45 teeth that were monitored for pulp revascularization, 75.6% showed clinical and radiographic signs of pulp healing and 24.4% showed signs of pulp necrosis and infection. Pulp healing was significantly related to the stage of root development of the transplant. Favourable PDL healing was observed in 87.6% of the transplants, while 13.5% showed signs of replacement resorption. PDL healing was significantly related to the stage of root formation of the transplanted tooth at the time of the surgery, the ease of handling and placement of the tooth, and the status of the alveolar bone at the recipient site at the time of the surgery. Overall success of tooth transplantation was 87.6%, and the survival rate was 94.4%.

CONCLUSIONS

Tooth transplantation carried out in children and adolescents demonstrated high success and survival, with the stage of root development influencing both the pulp and PDL healing of the transplanted teeth.

摘要

背景/目的:牙自体移植已被提倡用于替代缺失牙或不适于修复的牙齿。本研究的目的是调查影响儿童人群牙齿移植成功的结果及预后因素。

材料与方法

从75例患者(89颗牙齿)的记录中提取数据。记录并分析人口统计学和预后因素,以观察移植牙牙周膜(PDL)和牙髓愈合的临床及影像学结果。

结果

移植时的平均年龄为13.2岁,平均随访观察期为2.6±1.8年,范围为12.0个月至9.9年。移植的主要原因是替换因牙外伤、先天性缺牙和牙折而缺失的上颌中切牙。在45颗监测牙髓血管再生的牙齿中,75.6%显示出牙髓愈合的临床和影像学迹象,24.4%显示出牙髓坏死和感染的迹象。牙髓愈合与移植牙根发育阶段显著相关。87.6%的移植牙观察到良好的PDL愈合,而13.5%显示出替代性吸收的迹象。PDL愈合与手术时移植牙根形成阶段、牙齿的操作和植入难易程度以及手术时受植部位的牙槽骨状况显著相关。牙齿移植的总体成功率为87.6%,存活率为94.4%。

结论

在儿童和青少年中进行的牙齿移植显示出较高的成功率和存活率,牙根发育阶段影响移植牙的牙髓和PDL愈合。

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