Verweij Jop P, van Westerveld Kees J H, Anssari Moin David, Mensink Gertjan, van Merkesteyn J P Richard
Resident Oral & Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Oral & Maxillofacial Surgery Resident, Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, the Netherlands.
J Oral Maxillofac Surg. 2020 Jan;78(1):35-43. doi: 10.1016/j.joms.2019.08.005. Epub 2019 Aug 14.
Three-dimensional (3D) autotransplantation is a technique for surgical transposition of a tooth to another site within one patient, using 3D printed replicas of the donor tooth. In this study, we evaluated intraoperative experiences during 3D autotransplantation of teeth.
A multicenter prospective clinical study was implemented. All procedures were performed using preoperative cone-beam computed tomography imaging and computer-assisted design with computer-assisted manufacturing resulting in a 3D replica of the donor tooth.
The 100 autotransplantation procedures (79 patients) included canines, premolars, molars, and 1 supernumerary tooth. In 82% of the procedures, the transplantation was performed with an extra-alveolar time of less than 1 minute and an immediate good fit of the donor tooth. In 14%, the extra-alveolar time was 1 to 3 minutes or multiple fitting attempts were necessary. In 4%, the extra-alveolar time exceeded 3 minutes. Difficulties during the procedures were caused by movement artifacts on the preoperative cone-beam computed tomography imaging, a long interval between the imaging and the procedure, or insufficient bone volume at the recipient site.
The use of a 3D printed donor tooth replica during autotransplantation procedures minimized the extra-alveolar time and intraoperative fitting attempts of transplants. This facilitated a quick and reliable treatment and enabled more difficult procedures.
三维（3D）自体牙移植是一种将牙齿手术移植到同一患者口腔内其他部位的技术，使用供体牙的3D打印复制品。在本研究中，我们评估了牙齿3D自体牙移植术中的经验。
开展了一项多中心前瞻性临床研究。所有手术均使用术前锥形束计算机断层扫描成像和计算机辅助设计以及计算机辅助制造，从而获得供体牙的3D复制品。
100例自体牙移植手术（79例患者）涉及犬齿、前磨牙、磨牙和1颗多生牙。在82%的手术中，牙槽外操作时间少于1分钟，供体牙即刻适配良好。14%的手术中，牙槽外操作时间为1至3分钟或需要多次适配尝试。4%的手术中，牙槽外操作时间超过3分钟。手术中的困难是由术前锥形束计算机断层扫描成像上的运动伪影、成像与手术之间的时间间隔过长或受植部位骨量不足导致的。
在自体牙移植手术中使用3D打印的供体牙复制品可将牙槽外操作时间和移植术中的适配尝试减至最少。这有助于实现快速可靠的治疗，并使更复杂的手术成为可能。
