Camargo Elisa Souza, Silva Rhafaela Ribeiro, Rodrigues Ádelin Olívia Lopes Joly, Andreis Patricia Kern Di Scala, Maciel José Vinicius Bolognesi, Luczyszyn Sônia Mara, de Souza Evelise Machado, Carneiro Everdan, Vanzela Nathália Juliana, Carlini João Luiz
Graduate Program in Dentistry - Orthodontics, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
Graduate Program in Dentistry - Restorative Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
Eur J Dent. 2024 May;18(2):692-699. doi: 10.1055/s-0043-1777048. Epub 2024 Jan 23.
The objective is to present a clinical case of dental autotransplantation managed with surgery, orthodontics, endodontics, periodontics, and aesthetic rehabilitation. A 10-year-old boy sought treatment after avulsion of the maxillary left central incisor, which was not reimplanted. Based on anamnesis, clinical examination, and complementary examinations, agenesis of the maxillary and mandibular second premolars except the mandibular right second premolar was observed. After a multidisciplinary planning, the space in the maxillary left central incisor region was opened to receive the transplanted mandibular right second premolar. The receptor site was created in a single surgical procedure. Pulp necrosis was noted in the transplanted tooth, which was treated endodontically, and the agenesis spaces were closed using fixed orthodontic appliances. After removing the appliance, gingivectomy with osteotomy was performed in the maxillary right central incisor and the transplanted tooth regions to harmonize the height and shape of the gingival contour. Next, aesthetic readjustment was performed with tooth whitening, using office and home techniques, followed by microabrasion of the vestibular surface of the maxillary right central incisor. Direct composite resin restorations were placed in the maxillary incisors, and the teeth were rehabilitated using incisal and palatal guides. A multidisciplinary approach is essential for reestablishing the function and aesthetics of complex cases involving dental autotransplantation.
目的是介绍一例通过外科手术、正畸、牙髓病学、牙周病学和美学修复进行管理的牙齿自体移植临床病例。一名10岁男孩在上颌左中切牙脱位后前来就诊,该牙齿未再植。根据病史、临床检查和辅助检查,发现除下颌右第二前磨牙外,上颌和下颌第二前磨牙均缺失。经过多学科规划,上颌左中切牙区域的间隙被打开,以容纳移植的下颌右第二前磨牙。在一次外科手术中创建了受体部位。移植牙出现牙髓坏死,进行了牙髓治疗,并用固定正畸矫治器关闭了缺失间隙。拆除矫治器后,对上颌右中切牙和移植牙区域进行了牙龈切除术和截骨术,以协调牙龈轮廓的高度和形状。接下来,采用诊室和家庭技术进行牙齿美白进行美学调整,随后对上颌右中切牙的前庭面进行微磨除。在上颌切牙中放置直接复合树脂修复体,并使用切端和腭侧导板对牙齿进行修复。对于涉及牙齿自体移植的复杂病例,多学科方法对于恢复功能和美观至关重要。
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