The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, China.
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
BMC Oral Health. 2022 Jan 11;22(1):5. doi: 10.1186/s12903-021-02030-z.
The activity of donor periodontal membrane is the key factor of autologous tooth healing. The application of digital aided design, 3D printing model and guide plate in autotransplantation of tooth (ATT) is expected to reduce the damage of periodontal membrane and preserve the activity of periodontal membrane, so as to improve the success rate of ATT. This study tried to prove the role of digital technology in improving the success rate of ATT, although there are differences in model accuracy in practice.
We included 41 tooth autotransplantation cases which assisted by 3D-printed donor models and surgical guides and divided them into two groups in accordance with whether the donor tooth could be placed successfully after the preparation of alveolar socket guided by the model tooth. Then, we compared and analyzed the preparation time of alveolar socket, extra-alveolar time, and number of positioning trials of the donor tooth between the two groups. We also included a comparison of the in vitro time of the donor tooth with that of 15 min. The incidence of complications was included in the prognostic evaluation.
The mean preparation time of the alveolar socket, mean extra-alveolar time of donor tooth, and mean number of positioning trials with donor tooth of 41 cases were 12.73 ± 6.18 min, 5.56 ± 3.11 min, and 2.61 ± 1.00, respectively. The group wherein the donor tooth cannot be placed successfully (15.57 ± 6.14 min, 7.29 ± 2.57 min) spent more preparation time of alveolar socket and extra-alveolar time than the group wherein the donor tooth can be placed successfully (9.75 ± 4.73 min, 3.75 ± 2.57 min). The number of positioning trials with the donor tooth of the group wherein the donor tooth cannot be placed successfully (3.19 ± 0.75) was higher than that of the other group (2.00 ± 0.86). There was no significant difference in survival rates between the two groups.
Compared with the traditional tooth autotransplantation, the introduction of computer-aided design combined with 3D printing of the model tooth and surgical guides evidently shortens the preparation time of the alveolar socket and the extra-alveolar time of the donor tooth and reduces the number of positioning trials with the donor tooth regardless of the shape deviation between the model and actual teeth.
供体牙周膜的活性是自体牙愈合的关键因素。数字化辅助设计、3D 打印模型和导板在自体牙移植(ATT)中的应用有望减少牙周膜的损伤,保持牙周膜的活性,从而提高 ATT 的成功率。本研究试图证明数字技术在提高 ATT 成功率方面的作用,尽管在实践中存在模型精度的差异。
我们纳入了 41 例经 3D 打印的供体模型和手术导板辅助的自体牙移植病例,并根据模型牙引导牙槽窝预备后供体牙能否成功放置,将其分为两组。然后,我们比较和分析了两组间牙槽窝预备时间、供体牙牙槽外时间和供体牙定位试验次数。我们还比较了离体时间与 15 分钟的比较。并发症的发生率包括在预后评估中。
41 例患者的牙槽窝预备时间、供体牙牙槽外时间和供体牙定位试验次数的平均值分别为 12.73±6.18 分钟、5.56±3.11 分钟和 2.61±1.00。供体牙不能放置成功的组(15.57±6.14 分钟,7.29±2.57 分钟)的牙槽窝预备时间和牙槽外时间均长于供体牙能放置成功的组(9.75±4.73 分钟,3.75±2.57 分钟)。供体牙不能放置成功组的供体牙定位试验次数(3.19±0.75)高于另一组(2.00±0.86)。两组间的存活率无显著差异。
与传统的自体牙移植相比,计算机辅助设计结合模型牙和手术导板的 3D 打印技术明显缩短了牙槽窝的预备时间和供体牙的牙槽外时间,减少了供体牙的定位试验次数,而不管模型与实际牙齿之间的形状偏差。