Park Soyoung, Lee Haena, Lee Eungyung, Jeong Taesung, Lee Hyeonjong, Shin Jonghyun
Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea.
Department of Pediatric Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea.
Children (Basel). 2023 Apr 11;10(4):708. doi: 10.3390/children10040708.
Autotransplantation is a potential treatment alternative when orthodontic traction of an impacted tooth is difficult. In this article, we describe two cases of guided autotransplantation of an impacted canine using a computer-aided designed and manufactured surgical template. The impacted canine was segmented on preoperative cone-beam computed tomography images to ensure a sufficient periodontal ligament space and placement of the donor tooth with the least pressure on it. The canine was virtually transposed using a simulation program considering the adjacent teeth. The surgical template, which was connected to the occlusal stop on adjacent teeth, was designed and 3D-printed with polymer resin. The recipient site was prepared using the surgical template, followed by immediate transplantation of the surgically extracted canine into the socket. The transplanted donor tooth was positioned in planned infra-occlusion to prevent occlusal interference. It was then splinted with the adjacent teeth for initial stabilization. During follow-up, one transplanted tooth showed pulp canal obliteration and the other had suspected pulp necrosis; endodontic treatment was performed. One year after the procedure, the periradicular condition of both teeth was favorable.
当阻生牙的正畸牵引困难时，自体牙移植是一种潜在的治疗选择。在本文中，我们描述了两例使用计算机辅助设计和制造的手术导板进行阻生尖牙引导自体牙移植的病例。在术前锥形束计算机断层扫描图像上对阻生尖牙进行分割，以确保有足够的牙周膜间隙，并使供牙在植入时受到的压力最小。使用考虑相邻牙齿的模拟程序对尖牙进行虚拟移位。连接到相邻牙齿咬合阻挡的手术导板采用聚合物树脂进行设计和3D打印。使用手术导板准备受植区，然后将手术拔除并立即移植的尖牙植入牙槽窝。将移植的供牙放置在计划的低位咬合，以防止咬合干扰。然后将其与相邻牙齿进行结扎以实现初步稳定。在随访期间，一颗移植牙出现牙髓腔闭塞，另一颗怀疑有牙髓坏死，均进行了根管治疗。术后一年，两颗牙齿的根尖周状况良好。
