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自体移植第三磨牙的中期结果和牙周预后因素:一项回顾性队列研究。

Mid-term outcomes and periodontal prognostic factors of autotransplanted third molars: A retrospective cohort study.

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.

Department of Endodontics, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

J Periodontol. 2021 Dec;92(12):1776-1787. doi: 10.1002/JPER.21-0074. Epub 2021 Apr 5.

Abstract

BACKGROUND

Tooth autotransplantation is a valid method for replacing non-restorable teeth. This study aimed to assess mid-term survival and success of autotransplanted third molars and the clinical periodontal parameters and factors predicting successful periodontal attachment apparatus regeneration.

METHODS

In total, 36 patients who had undergone extraction and subsequent autotransplantation of 36 third molars using virtual planning and computer-aided rapid prototyping models by an oral surgeon and endodontist were eligible. Probing pocket depth (PPD), gingival recession (REC), clinical attachment level (CAL), pulpal and periapical healing, root resorption, and radiographic bone loss (RBL) were evaluated. Additionally, a questionnaire evaluated patient-reported outcomes.

RESULTS

The mean age of the participants was 30.2 years with a mean follow-up duration of 29.42 ± 14.56 months. The overall survival and success rates were 97.2% and 91.7%, respectively. No statistically significant differences were found in success and survival rates between open and closed apex groups or between compromised and intact buccal bone groups. No signs of pulp necrosis were found in the open apex group. Progressive replacement resorption was detected in one closed apex case. The mean PPD was 2.7 ± 0.45 mm for all transplanted teeth. REC was 0.13 mm higher in transplanted teeth than in previous hopeless teeth. CAL changes were neither clinically relevant (-0.17 ± 0.66 mm) nor statistically significant. The reported patient satisfaction was high.

CONCLUSIONS

Autotransplantation of third molars is a predictable treatment method, with a 2.5-year cumulative tooth survival and success of 97.2% and 91.7%, respectively, which were not influenced by recipient site integrity or root development.

摘要

背景

牙自体移植是一种有效的方法,可用于替代不可修复的牙齿。本研究旨在评估自体移植第三磨牙的中期存活率和成功率,以及预测牙周附着器成功再生的临床牙周参数和因素。

方法

共有 36 名患者符合条件,他们接受了口腔外科医生和牙髓病医生通过虚拟规划和计算机辅助快速成型模型进行的 36 颗第三磨牙的拔除和随后的自体移植。探测袋深度(PPD)、牙龈退缩(REC)、临床附着水平(CAL)、牙髓和根尖愈合、根吸收和放射状骨丢失(RBL)均进行了评估。此外,还通过问卷调查评估了患者报告的结果。

结果

参与者的平均年龄为 30.2 岁,平均随访时间为 29.42±14.56 个月。总体存活率和成功率分别为 97.2%和 91.7%。开放根尖组和闭合根尖组、受损伤颊侧骨组和完整颊侧骨组之间,成功率和存活率无统计学差异。开放根尖组未发现牙髓坏死迹象。在一个闭合根尖病例中发现进行性替换性吸收。所有移植牙的平均 PPD 为 2.7±0.45mm。移植牙的 REC 比先前的无望牙高 0.13mm。CAL 变化既无临床意义(-0.17±0.66mm),也无统计学意义。报告的患者满意度很高。

结论

自体移植第三磨牙是一种可预测的治疗方法,2.5 年累积牙存活率和成功率分别为 97.2%和 91.7%,不受受植体部位完整性或牙根发育的影响。

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