Department of Oral Surgery Clinic, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital). Research Institute of Stomatology of Xinjiang Uygur Autonomous Region, Urumqi, China.
Department of Maxillofacial Tumor Surgery, The First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital). Research Institute of Stomatology of Xinjiang Uygur Autonomous Region, Urumqi, China.
Dent Traumatol. 2024 Oct;40(5):573-585. doi: 10.1111/edt.12958. Epub 2024 Apr 20.
BACKGROUND/AIMS: The purpose of this study was to observe the outcome of mature third molars transplantation into surgically created sockets with the assistance of computer designed three dimensional (3-D) printed replicas and compare its outcome with the conventional fresh socket autotransplantation.
This study included total of 96 mature third molars autotransplanted in 96 cases with the guidance of computer designed 3-D printed replicas. Forty-eight teeth autotransplanted into surgically created sockets were enrolled into the surgically created socket group and 48 teeth conventionally autotransplanted into fresh sockets were enrolled into the fresh socket group. In the surgically created socket group, mature third molars were autotransplanted into surgically prepared sockets at the site of previously missed or extracted molars in the alveolar bone and in the fresh socket group, autotransplantation of mature third molars were performed in fresh sockets of extracted diseased molars simultaneously. After transplantation, the visual analogue scale (VAS) score, Landry Wound Healing Index (LWHI), mobility and probing depth (PD) of the transplanted teeth were measured and the patient satisfaction questionnaire were held in both group. All patients underwent clinical and radiographic examinations during the follow-up.
During the mean follow-up period of 47.63 ± 16.78 months (range 18-78 months), 92 out of 96 teeth remained in situ without clinical or radiographic complications with overall success rate of 95.83%. No statistically significant differences were found in success and survival rates between the two group. The average extra-oral time of the donor teeth were 60.76 ± 22.41 s and mean positioning trials of the donor teeth were 2.43 ± 1.19. The VAS score at Day 1 in the surgically created socket group was higher than the fresh socket group (p < .05). LWHI scores in the surgically created group were lower than the fresh socket group during the first 2 weeks (p < .05). The degree of mobility of the transplanted teeth in both group showed no statistically significant difference during the first 3 months. PD in the surgically created group were higher than the fresh socket group in the first month but there were no statistically significant difference after 1 month. Twenty-six out of 48 cases in the surgically created group needed crown restoration while only 10 cases went through crown restoration in the fresh socket group. Most patients in both group were satisfied with the treatment.
Autogenous mature third molars transplantation into surgically created sockets is as effective as conventional fresh socket transplantation. This technique is worth recommending in carefully selected cases and optimistic results can be achieved.
背景/目的:本研究旨在观察使用计算机设计的三维(3-D)打印复制品辅助将成熟的第三磨牙移植到手术创建的牙槽窝中的结果,并将其与传统的新鲜牙槽窝自体移植进行比较。
本研究共纳入 96 例患者的 96 颗成熟第三磨牙自体移植,所有患者均在计算机设计的 3-D 打印复制品的指导下进行移植。48 颗移植到手术制备的牙槽窝中的牙齿被纳入手术制备牙槽窝组,48 颗移植到新鲜牙槽窝中的牙齿被纳入新鲜牙槽窝组。在手术制备牙槽窝组中,将成熟的第三磨牙自体移植到先前缺失或拔牙的牙槽骨中的手术制备牙槽窝中,在新鲜牙槽窝组中,将成熟的第三磨牙自体移植到同时拔牙的患病牙齿的新鲜牙槽窝中。移植后,测量移植牙的视觉模拟评分(VAS)、兰德里伤口愈合指数(LWHI)、松动度和探诊深度(PD),并在两组中进行患者满意度问卷调查。所有患者在随访期间均接受临床和影像学检查。
在平均 47.63±16.78 个月(18-78 个月)的随访期间,96 颗牙齿中有 92 颗无临床或影像学并发症,总体成功率为 95.83%。两组间的成功率和存活率无统计学差异。供牙的平均口外时间为 60.76±22.41 秒,供牙的平均定位试验为 2.43±1.19。手术制备牙槽窝组第 1 天的 VAS 评分高于新鲜牙槽窝组(p<.05)。在最初的 2 周内,手术制备牙槽窝组的 LWHI 评分低于新鲜牙槽窝组(p<.05)。两组移植牙的松动度在最初 3 个月内无统计学差异。手术制备牙槽窝组在第 1 个月的 PD 高于新鲜牙槽窝组,但 1 个月后无统计学差异。手术制备牙槽窝组 26 例患者需要进行牙冠修复,而新鲜牙槽窝组仅 10 例患者需要进行牙冠修复。两组患者多数对治疗结果满意。
自体成熟第三磨牙移植到手术制备的牙槽窝中与传统的新鲜牙槽窝移植同样有效。在精心选择的病例中,该技术值得推荐,可获得乐观的结果。