Rugani Petra, Brcic Iva, Magyar Marton, Schwarze Uwe Yacine, Jakse Norbert, Ebeleseder Kurt
Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria.
Diagnostic and Research Institute of Pathology, Comprehensive Cancer Centre Graz, Medical University of Graz, 8010 Graz, Austria.
J Clin Med. 2023 Sep 16;12(18):6008. doi: 10.3390/jcm12186008.
Autotransplantation of a mature tooth usually leads to pulpal necrosis. Root canal treatment is recommended to prevent related inflammatory complications a few weeks after surgery. Extraoral root-end resection may facilitate reperfusion and obviate root canal treatment, but cannot be pictured with conventional dental radiography at this point in time. In the case of a lower mature transplanted molar, contrast-enhanced magnetic resonance imaging proved to be a feasible method for visualizing pulp revascularization just 4 weeks after autotransplantation. Consequently, root canal treatment was obviated. Nevertheless, the tooth had to be extracted 18 months postoperatively due to external cervical root resorption, probably caused by the extraction trauma. This allowed the histological processing and examination of the newly generated intracanal tissue. Uninflamed fibrovascular connective tissue was found, while odontoblasts or cementoblast-like cells were absent. These findings indicated that it was most likely stem cells from the bone marrow and the periodontal ligament that drove the regeneration.
成熟牙齿的自体移植通常会导致牙髓坏死。建议在术后几周进行根管治疗，以预防相关的炎症并发症。口外牙根切除术可能有助于再灌注并避免根管治疗，但目前传统牙科X线摄影无法显示。对于一颗低位成熟移植磨牙，对比增强磁共振成像被证明是一种可行的方法，可在自体移植后仅4周可视化牙髓再血管化。因此，无需进行根管治疗。然而，术后18个月该牙齿因可能由拔牙创伤引起的外部颈根吸收而不得不拔除。这使得能够对新生成的根管内组织进行组织学处理和检查。发现了无炎症的纤维血管结缔组织，而未发现成牙本质细胞或成牙骨质细胞样细胞。这些发现表明，最有可能是来自骨髓和牙周韧带的干细胞推动了再生。
