上颌前磨牙自体移植至恒牙脱落后区域并进行修复的多学科治疗方法:一项6年随访的病例报告
Multidisciplinary Approach for Autotransplantation and Restoration of a Maxillary Premolar into an Area of an Avulsed Anterior Tooth: A Case Report with a 6-Year Follow-up.
作者信息
Berlin-Broner Yuli, Torrealba Ysidora, Flores-Mir Carlos, Levin Liran
机构信息
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
出版信息
J Endod. 2023 May;49(5):590-596. doi: 10.1016/j.joen.2023.02.007. Epub 2023 Feb 24.
The loss of an anterior tooth because of avulsion has been reported in up to 3% of dental injuries. Management alternatives, such as implant-supported restorations and a fixed partial denture, are contraindicated in growing patients because of the continuous growth of the alveolar process. At the same time, orthodontic treatment for gap closure will result in asymmetry and will require adjustment of the adjacent healthy teeth. Therefore, restoring a missing tooth imposes a treatment challenge, especially in children and young adults. Tooth autotransplantation is a treatment modality with high reported survival and success rates that overcome these mentioned limitations. It might also help to preserve the alveolar bone and the soft tissues. This case report describes a multidisciplinary approach for managing a 13-year-old boy who lost his right maxillary central incisor because of a fall. Management included autotransplantation of the left maxillary second premolar to the site of the lost right maxillary central incisor, management of external inflammatory resorption with an endodontic treatment, orthodontic treatment, and aesthetic restoration of the area with composite resin crowns that can be adapted to the expected changes of the jaws during the craniofacial growing period. At the 6-year follow-up, the teeth demonstrated a positive outcome.
据报道,因牙脱位导致的上前牙缺失在牙外伤中占比高达3%。由于牙槽突持续生长,种植支持修复体和固定局部义齿等治疗方案对于正在生长发育的患者是禁忌的。与此同时,通过正畸治疗关闭间隙会导致不对称,并且需要调整相邻的健康牙齿。因此,修复缺失牙带来了治疗挑战,尤其是在儿童和年轻成年人中。牙自体移植是一种治疗方式,据报道其存活率和成功率很高,克服了上述局限性。它还有助于保留牙槽骨和软组织。本病例报告描述了一种多学科方法,用于治疗一名13岁男孩,该男孩因摔倒失去了右上颌中切牙。治疗措施包括将左上颌第二前磨牙自体移植到右上颌中切牙缺失部位,通过牙髓治疗处理外部炎性吸收,进行正畸治疗,以及在颅面生长期间用复合树脂冠对该区域进行美学修复,以适应颌骨的预期变化。在6年的随访中,牙齿显示出良好的结果。