Ferraresso Lucas Fernando de Oliveira Tomáz, Besegato João Felipe, Maler Gustavo Lopes, Takahashi Ricardo, Stábile Glaykon Alex Vitti, Hoeppner Márcio Grama
Department of Oral Medicine and Pediatric Dentistry, State University of Londrina (UEL), Londrina, PR, Brazil.
School of Dentistry (FAODO), Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
J Esthet Restor Dent. 2025 Feb;37(2):307-313. doi: 10.1111/jerd.13284. Epub 2024 Jul 25.
This case report describes the multidisciplinary approach performed in a 9-year-old male patient with dental agenesia affecting teeth 21 and 22. Autotransplantation of the right upper second premolar with incomplete rhizogenesis to the missing area was combined with coronary reshaping with resin composite and orthodontic therapy. The treatment began with the extraction of the deciduous upper left central incisor, bone preparation for the recipient site of the donor tooth, atraumatic extraction of the right upper second premolar and immediate autotransplantation in the surgically prepared recipient site. Subsequently, sutures to reposition the flap and a rigid splint were performed. After 12 months, coronary reshaping of the autotransplanted tooth with resin composite was carried out. Orthodontic treatment involving the use of a fixed appliance was used to correct the interdental spaces and achieve adequate occlusion. Clinical and radiographic follow-up 10 years after tooth autotransplantation and 9 years after reshaping revealed partial obliteration of the pulp chamber, root resorption, ankylosis and the presence of endodontic treatment.
The long-term outcomes highlighted that tooth autotransplantation represents a biologically and cost-effective procedure for replacing missing teeth in young patients, particularly in cases of incomplete rhizogenesis of the autotransplanted tooth.
This case report discusses tooth autotransplantation and resin composite reshaping as viable and long-term clinical options for treating young patients with dental agenesis.
本病例报告描述了对一名9岁男性患者采取的多学科治疗方法,该患者患有牙缺失,涉及21和22号牙。将右上第二前磨牙牙根发育不全的牙齿自体移植到缺失部位,并结合树脂复合材料进行冠部重塑和正畸治疗。治疗开始时,拔除左上乳中切牙,为供体牙的受体部位进行骨制备,无创伤性拔除右上第二前磨牙,并立即将其自体移植到手术制备的受体部位。随后,进行缝合以重新定位皮瓣并安装坚固夹板。12个月后,用树脂复合材料对自体移植牙进行冠部重塑。采用固定矫治器进行正畸治疗,以纠正牙间隙并实现适当的咬合。牙齿自体移植10年后和重塑9年后的临床及影像学随访显示,牙髓腔部分闭塞、牙根吸收、牙根粘连以及存在牙髓治疗情况。
长期结果表明,牙齿自体移植是年轻患者替代缺失牙的一种生物学上可行且具有成本效益的方法,特别是在自体移植牙牙根发育不全的情况下。
本病例报告讨论了牙齿自体移植和树脂复合材料重塑作为治疗牙缺失年轻患者的可行且长期的临床选择。