Li Y Q, Hui X Y, Xu G J, Ma Y Y, Yang X, Xu J, Zhu Q L, Zhang Z M, Wu X, Hou R
Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China.
Department of Periodontology, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an 710032, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2022 May 9;57(5):495-502. doi: 10.3760/cma.j.cn112144-20220209-00050.
To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (<0.001), sex (=0.008), smoking (<0.001), position of recipient area (0.001), height of alveolar bone in recipient area (0.001), time of donor tooth (0.001), use of donor model (0.001) and initial stability (0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (β=-2.812, 0.049), alveolar bone height (β=1.521, 0.020), donor time (β=-2.001, 0.019), use of donor model (β=1.666, 0.034) and initial stability (β=-1.417, 0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth , use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth , taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.
筛选并分析自体牙移植修复单颗牙缺失预后的影响因素，为手术预后的临床判断提供参考。2017年1月至2019年12月，第四军医大学口腔医学院口腔颌面外科共176例患者（188颗牙）接受了自体牙移植，其中男性85颗牙，女性103颗牙。年龄为（33.0±9.8）岁（16 - 65岁）。总结并归纳自体牙移植修复单颗牙缺失预后的可能影响因素，记录并评判临床及影像学资料。对患者既往病历中的手术记录及影像资料进行回顾性分析。采用生存分析方法进行统计学分析，筛选出影响移植牙累积生存率的因素。188颗移植牙的5年累积生存率为88.4%。单因素Log-Rank分析显示，年龄（<0.001）、性别（=0.008）、吸烟（<0.001）、受植区位置（0.001）、受植区牙槽骨高度（0.001）、供牙时间（0.001）、供牙模型的使用（0.001）及初始稳定性（0.001）与移植牙累积生存率显著相关。多因素Cox比例风险回归分析显示，吸烟（β=-2.812，0.049）、牙槽骨高度（β=1.521，0.020）、供牙时间（β=-2.001，0.019）、供牙模型的使用（β=1.666，0.034）及初始稳定性（β=-1.417，0.033）与移植牙累积生存率显著相关。吸烟、受植区牙槽骨高度、供牙时间、供牙模型的使用及初始稳定性可预测自体牙移植的预后。术中使用供牙模型、缩短供牙时间、采取有效方法恢复牙槽骨高度、保持良好的初始稳定性及术后进行良好的口腔健康教育，可获得较好的移植牙预后。
