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使用 3 维打印引导模板和供体牙复制体对成熟第三磨牙进行自体移植的结果。

Outcome of Autotransplantation of Mature Third Molars Using 3-dimensional-printed Guiding Templates and Donor Tooth Replicas.

机构信息

Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.

Private Practice, Barcelona, Spain.

出版信息

J Endod. 2018 Oct;44(10):1567-1574. doi: 10.1016/j.joen.2018.07.007. Epub 2018 Aug 25.

Abstract

Autotransplantation exhibits a number of advantages compared with other treatment options (ie, dental implants or fixed partial prostheses), such as greater resistance to occlusal loading, maintenance of the periodontal ligament and surrounding bone, and the potential for better esthetics. The aim of this study was to determine clinical outcomes for autotransplanted teeth with complete root formation using 3-dimensional-printed guiding templates and tooth replicas. Twenty-seven third molars with completely formed roots were autotransplanted. Each donor tooth and recipient site were examined clinically and radiographically (periapical radiographs). A selective cone-beam computed tomographic scan was taken of each donor tooth and recipient site. The images of the selected donor teeth were segmented and saved as stereolithography files. Similar to virtual planning of dental implants, correct angulation, rotation, and accurate positioning of the donor teeth were predefined using the stereolithography files. According to the virtually defined positions and dimensions of the donor teeth, 3-dimensional guiding templates and donor tooth replicas were printed. All autotransplantations were performed according to 1 treatment protocol and surgical technique. In 22 of the 24 transplanted teeth, no inflammation occurred during the healing period. At 2 years, no pathologic radiolucency or tooth resorption was observed in the 22 donor teeth. The autotransplanted teeth fulfilled the success criteria in 22 cases for a 91.7% success rate. Digital planning could potentially provide an accurate alternative to current autotransplantation techniques.

摘要

自体移植与其他治疗选择(例如,种植牙或固定局部义齿)相比具有许多优势,例如对咬合负荷的抵抗力更大、牙周韧带和周围骨的维持以及更好的美观效果的潜力。本研究的目的是使用 3D 打印引导模板和牙齿复制品确定完全形成根的自体移植牙齿的临床结果。共 27 颗完全形成根的第三磨牙被自体移植。每个供体牙和受体部位都进行了临床和影像学检查(根尖片)。对每个供体牙和受体部位进行了选择性锥形束 CT 扫描。所选供体牙的图像被分割并保存为立体光刻文件。类似于种植牙的虚拟规划,使用立体光刻文件预先定义供体牙的正确角度、旋转和准确位置。根据供体牙的虚拟定义位置和尺寸,打印了 3D 引导模板和供体牙复制品。所有自体移植均根据 1 种治疗方案和手术技术进行。在 24 颗移植牙中的 22 颗中,愈合期没有发生炎症。2 年后,在 22 颗供体牙中未观察到病理性不透明或牙齿吸收。在 22 例中,自体移植牙满足成功标准,成功率为 91.7%。数字化规划有可能为当前的自体移植技术提供一种准确的替代方法。

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