Faculty of Odontology, University of Iceland, Reykjavík, Iceland.
Faculty of Odontology, University of Iceland, Reykjavík, Iceland.
Am J Orthod Dentofacial Orthop. 2024 Nov;166(5):480-489.e3. doi: 10.1016/j.ajodo.2024.07.003. Epub 2024 Jul 31.
The objective of this study was to report the long-term outcome of autotransplantation of premolars to other premolar recipient sites.
The sample was limited to adolescents seeking orthodontic treatment, and all had 1 or 2 premolars transplanted to a recipient site in which a premolar was congenitally missing. The transplantations were performed between 1980 and 2008, comprising 29 premolars in 22 males and 28 premolars in 22 females. Systematic clinical and radiographic follow-up varied from 1 year to 36.8 years, with a mean observation time of 18.9 years and a median of 19.2 years. Of the 57 transplanted teeth, 52 were subjected to orthodontic forces.
A total of 9 of 57 teeth (15.8%) were lost during the observation period, and 8 of 9 lost teeth had been functional for at least 9 years posttransplantation. Of the 48 surviving transplants, 6 did not meet the criteria for success, giving an overall success rate of 73.7%. Complications were diagnosed within 5 years from the transplantation in 4 of 57 teeth (7.0%) and later in 11 of 57 (19.3%). The Kaplan-Meier survival curve shows that the complication-free proportion of transplants decreased at a constant rate over the observation time. The average survival time, taking censoring into account during follow-up of 36.8 years, was estimated as 28.5 years. The complications in the 15 teeth were classified into 4 categories: periapical lesions (6 teeth), inflammatory resorption (5 teeth), abrupt fracture (2 teeth), and ankylosis (2 teeth).
Overall, premolar transplants in all stages of root formation have high success and survival rates. Transplants with complications may survive temporarily and preserve critical arch space and alveolar bone. Transplants with normal healing may have latent weaknesses that can eventually affect long-term survival.
本研究旨在报告磨牙自体移植到其他磨牙缺失部位的长期疗效。
本研究样本仅限于寻求正畸治疗的青少年，所有患者均有 1 或 2 颗磨牙被移植到先天缺失 1 颗或 2 颗磨牙的受植部位。这些移植手术在 1980 年至 2008 年间进行，共涉及 22 名男性患者的 29 颗磨牙和 22 名女性患者的 28 颗磨牙。系统性临床和影像学随访时间从 1 年到 36.8 年不等，平均观察时间为 18.9 年，中位数为 19.2 年。在 57 颗移植牙中，有 52 颗牙受到正畸力的作用。
在观察期间，共有 9 颗（15.8%）牙丢失，其中 8 颗失牙在移植后至少 9 年已具有功能性。在 48 颗存活的移植牙中，有 6 颗牙不符合成功标准，总成功率为 73.7%。在 57 颗移植牙中，有 4 颗（7.0%）在移植后 5 年内和 11 颗（19.3%）在移植后 5 年以上被诊断出并发症。Kaplan-Meier 生存曲线显示，在 36.8 年的观察期间，无并发症的移植牙比例以恒定的速度下降。考虑到随访 36.8 年的截尾，平均生存时间估计为 28.5 年。15 颗牙齿的并发症分为 4 类：根尖病变（6 颗牙）、炎性吸收（5 颗牙）、突然折断（2 颗牙）和骨粘连（2 颗牙）。
总体而言，各发育阶段的磨牙移植具有较高的成功率和存活率。伴有并发症的移植牙可能暂时存活，保留重要的牙弓间隙和牙槽骨。愈合正常的移植牙可能存在潜在的弱点，最终可能影响长期存活率。
