Murata Masaru, Nakanishi Yasuhiro, Kusano Kaoru, Hirose Yukito, Tazaki Junichi, Akazawa Toshiyuki, Mizoguchi Itaru
Division of Regenerative Medicine, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan.
Division of Fixed Prosthodontics and Oral Implantology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan.
J Funct Biomater. 2022 Jun 16;13(2):82. doi: 10.3390/jfb13020082.
This clinical report describes immediate tooth auto-transplantation with an autograft of partially demineralized dentin/cementum matrix (pDDM), based on an orthodontic treatment plan for a 16-year-old male patient with a congenital missing tooth (#45). First, vital teeth (#14, #24) were extracted, and root canal filling (#14) was immediately performed with the support of a fixation device. Simultaneously, the tooth (#24) was crushed in an electric mill for 1 min, and the crushed granules were partially demineralized in 2% HNO solution for 20 min as the graft material. Next, the donor tooth was transplanted into the created socket (#45), and stabilized using an enamel bonding agent. The wet pDDM was loaded into the location of the congenital missing tooth, and the flap was repositioned. The bonding agent for stabilization was removed at 28 days, and also small contact points between the transplanted tooth and the upper premolar (#14) were added using photopolymerizable composite resin. X-ray photos were taken sequentially, and there were no postoperative complications. The radiographic images showed that the periodontal ligament space and alveolar ridge line could be observed at 18 months. The pDDM was harmonized with the mandible, and the remodeled bone-like shadow was observed in the graft region. We concluded that immediate tooth transplantation with root canal fillings and autogenous pDDM may be a valuable alternative to dental implanting or bridge formation for patients with a congenital missing tooth, followed by orthodontic treatment.
本临床报告描述了基于一名16岁先天性缺牙（#45）男性患者的正畸治疗计划，使用部分脱矿牙本质/牙骨质基质（pDDM）自体移植进行即刻牙自体移植的情况。首先，拔除健康牙齿（#14、#24），并在固定装置的支持下立即对#14进行根管充填。同时，将牙齿（#24）在电动研磨机中研磨1分钟，研磨后的颗粒在2%硝酸溶液中部分脱矿20分钟作为移植材料。接下来，将供体牙植入所制备的牙槽窝（#45），并用釉质粘结剂固定。将湿的pDDM填入先天性缺牙部位，然后将瓣复位。28天时去除用于固定的粘结剂，并使用可光固化复合树脂在移植牙与上前磨牙（#14）之间添加小的接触点。依次拍摄X线照片，无术后并发症。影像学图像显示，18个月时可观察到牙周膜间隙和牙槽嵴线。pDDM与下颌骨协调一致，移植区域观察到重塑的骨样阴影。我们得出结论，对于先天性缺牙患者，在正畸治疗之后，根管充填联合自体pDDM即刻牙移植可能是种植牙或搭桥修复的一种有价值的替代方法。
