Grün Pascal, Pfaffeneder-Mantai Florian, Bandura Patrick, Schneider Benedikt, Degel Ulli, Grün Ann-Sophie, Turhani Dritan
Department of Dentistry, Center for Oral and Maxillofacial Surgery.
Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria.
Ann Med Surg (Lond). 2023 Apr 5;85(5):1991-1997. doi: 10.1097/MS9.0000000000000475. eCollection 2023 May.
Autologous tooth transplantation is the transplantation of an erupted, partially erupted, or unerupted tooth from one site to another in an individual. This is expected to maintain alveolar bone volume through physiological stimulation of the periodontal ligament (PDL). Tooth transplantation can be used for the closure of oroantral communication. As a simple, useful, and minimally invasive method, it should be considered a surgical option when a donor tooth is available in indicated cases. Herein, the authors report the case of a 20-year-old female patient whose left permanent maxillary first molar had to be extracted due to a longitudinal fracture and radicular cyst in the maxillary sinus floor. After the extraction, tooth 28 was exposed through an osteotomy and positioned in the gap. Nineteen years later, the autologous grafted tooth 28 could no longer be retained due to massive external resorption and was replaced by an implant. Human PDL stem cells can differentiate into bone-, fiber-, and cementum-forming cells and have the potential to build a PDL complex. Therefore, care must be taken to avoid damaging the PDL of the donor tooth during extraction. Autotransplanted teeth are expected to retain the alveolar bone volume. This case demonstrates the use of a transplanted tooth 28 for the treatment of a maxillary defect caused by the extraction of tooth 26 and removal of a radicular cyst. External resorption and regeneration of the bone of the maxillary sinus floor around the transplanted tooth occurred after 19 years.
自体牙移植是将一颗已萌出、部分萌出或未萌出的牙齿从个体的一个部位移植到另一个部位。预计这将通过对牙周韧带（PDL）的生理刺激来维持牙槽骨体积。牙齿移植可用于封闭口腔上颌窦瘘。作为一种简单、实用且微创的方法，在有合适供体牙的特定病例中，应将其视为一种手术选择。在此，作者报告了一例20岁女性患者的病例，该患者因上颌窦底纵折及根端囊肿，其左上颌第一恒磨牙不得不拔除。拔牙后，通过截骨术暴露28号牙并将其置于缺隙处。19年后，由于大量外部吸收，自体移植的28号牙无法保留，被种植体替代。人牙周膜干细胞可分化为成骨细胞、成纤维细胞和牙骨质形成细胞，并有构建牙周膜复合体的潜力。因此，拔牙过程中必须小心避免损伤供体牙的牙周膜。自体移植牙有望保留牙槽骨体积。本病例展示了使用移植的28号牙治疗因拔除26号牙和切除根端囊肿导致的上颌骨缺损。移植牙周围上颌窦底骨在19年后发生了外部吸收和再生。
