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从概念到临床实践:自体移植技术及其对牙科影响的综述

From Concept to Clinical Practice: A Review of Autotransplantation Techniques and Their Impact on Dentistry.

作者信息

Ajay S Vandana, Vishnani Rozina

机构信息

Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 14;16(8):e66904. doi: 10.7759/cureus.66904. eCollection 2024 Aug.

Abstract

The goal of autotransplantation of teeth (ATT) is to provide the patient with a functioning tooth to replace a missing one. In dentistry, this surgery has gained significant approval and popularity; nonetheless, there is still a shortage of thorough evidence about its long-term effects. Tooth transplantation has a rich historical pedigree, and the main factors determining its success are the extra-alveolar period, proper splinting, periodontal ligament treatment, and root growth stage. With its high reported survival rate, autotransplantation is a potential therapeutic option, especially when it comes to replacing damaged anterior maxillary teeth. Collaboration between orthodontists, pediatric dentists, restorative dentists, and oral and maxillofacial surgeons is necessary for the successful execution of this treatment. The extra-alveolar period, proper splinting, periodontal ligament treatment, and the stage of root growth are the main factors that determine success. Although there are many applications for autotransplantation, a good functional and cosmetic result depends on careful patient selection and a proper surgical approach. It is not practical to replace lost teeth in children and teenagers with bridgework or implants as this may interfere with the proper development of the alveolar process and other facial bones. As such, these techniques are not recommended. Alternatively, implanting a tooth from the same person without fully forming its roots might be a good substitute. This method promotes improved mastication, speech, dentofacial development, aesthetics, and arch form integrity by enabling unhindered alveolar growth and root development. Although tooth autotransplantation has not been widely used in clinical dentistry, it is currently seen as a viable option that can replace traditional prosthetics and implant rehabilitation in both financial and medical terms. This review examines several benefits, possible iatrogenic harms, side effects, and important variables that might affect the result of the transplant, in addition to suitable criteria for the best-case selection. It also offers recommendations based on the literature.

摘要

牙齿自体移植(ATT)的目标是为患者提供一颗能正常发挥功能的牙齿,以替代缺失的牙齿。在牙科领域,这种手术已获得广泛认可且颇受欢迎;然而,关于其长期效果的全面证据仍然不足。牙齿移植有着丰富的历史渊源,决定其成功的主要因素包括牙槽外阶段、恰当的固定、牙周韧带处理以及牙根生长阶段。由于自体移植的存活率较高,它是一种潜在的治疗选择,尤其在替换受损的上颌前牙时。正畸医生、儿童牙医、修复牙医以及口腔颌面外科医生之间的协作对于成功实施该治疗至关重要。牙槽外阶段、恰当的固定、牙周韧带处理以及牙根生长阶段是决定成功的主要因素。尽管自体移植有许多应用,但良好的功能和美观效果取决于仔细的患者选择和恰当的手术方法。用桥体或种植体替代儿童和青少年缺失的牙齿并不实际,因为这可能会干扰牙槽突和其他面部骨骼的正常发育。因此,不推荐这些技术。另外,移植同一人尚未完全形成牙根的牙齿可能是一个不错的替代方法。这种方法通过促进牙槽无阻碍生长和牙根发育,改善咀嚼、言语、牙颌面发育、美观以及牙弓形态的完整性。尽管牙齿自体移植在临床牙科中尚未广泛应用,但目前在经济和医学方面,它都被视为一种可行的选择,可以替代传统修复和种植修复。本综述除了探讨最佳病例选择的合适标准外,还研究了自体移植的若干益处、可能的医源性损害、副作用以及可能影响移植结果的重要变量。它还根据文献提供了建议。

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本文引用的文献

1
A step-by step guide for autotransplantation of teeth.牙齿自体移植分步指南。
Dent Traumatol. 2023 Jul;39 Suppl 1:70-80. doi: 10.1111/edt.12819. Epub 2023 Feb 3.
2
Up-to-Date Approach in the Treatment of Impacted Mandibular Molars: A Literature Review.下颌阻生磨牙治疗的最新方法:文献综述
Turk J Orthod. 2020 May 21;33(3):183-191. doi: 10.5152/TurkJOrthod.2020.19059. eCollection 2020 Sep.
3
Autotransplantation of teeth in humans: a systematic review and meta-analysis.人类牙齿自体移植:系统评价与荟萃分析
Clin Oral Investig. 2015 Jul;19(6):1157-79. doi: 10.1007/s00784-015-1473-9. Epub 2015 Apr 24.
5
Tooth autotransplantation as a treatment option: a review.牙齿自体移植作为一种治疗选择:综述
J Clin Pediatr Dent. 2010 Winter;35(2):129-35. doi: 10.17796/jcpd.35.2.97816254u2140x88.
8
Biological tooth replacement.生物牙齿替换
J Anat. 2006 Oct;209(4):503-9. doi: 10.1111/j.1469-7580.2006.00622.x.

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