Akhlef Yousra, Hosseini Mandana, Schwartz Ole, Andreasen Jens O, Gerds Thomas Alexander, Jensen Simon Storgård
Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Oral and Maxillofacial Surgery, Zealand University Hospital, Zealand, Denmark.
Dent Traumatol. 2025 Jun;41(3):322-337. doi: 10.1111/edt.13025. Epub 2024 Dec 11.
BACKGROUND/AIM: Autotransplantation is a well-documented procedure for replacing missing teeth in the anterior maxilla. This retrospective study aims to evaluate long-term survival rate, success rate as well as esthetics and patient-reported outcome of premolars autotransplanted to the anterior maxilla and secondarily to identify potential prognostic factors for survival, success, esthetic, and biological complications.
One hundred and twenty-two patients with 153 transplants were assessed on survival rate and potential prognostic factors, while 50 patients with 61 autotransplanted premolars underwent clinical, radiographic, and esthetic assessment. Clinical and radiographic parameters were recorded. Esthetic outcomes were evaluated using a comprehensive score system comparing transplanted teeth to neighboring tooth. All patients filled in a questionnaire about the esthetic outcome of the treatment.
The survival rate of transplants after 16-38 years was 76%, with the majority showing no periodontal complications (95%). Radiographically, 46% of transplanted premolars showed no signs of pathosis. Ankylosis and inflammatory resorption were observed in 19% and 16%, respectively. Prognostic factors such as donor tooth type and root stage did not significantly affect transplant survival. Premolars transplanted at an immature stage had a significant lower risk of ankylosis, compared to more mature transplants. Esthetically, 72% of the transplants matched their neighboring teeth, and taking the biological success into consideration an overall success rate was 57.3%. In total, 71% of all patients were esthetically satisfied with their autotransplant, 18% were fairly satisfied, and 11% were dissatisfied.
The transplants demonstrated high survival rate, albeit with biological complications such as ankylosis and inflammatory root resorption. Developmental stage of the root at the time of transplantation had a significant influence on ankylosis of transplanted teeth. Esthetic outcomes were generally satisfactory, although challenges were noted with certain restoration types and donor tooth selections. Overall, the majority of patients expressed satisfaction with their autotransplanted teeth.
背景/目的：自体移植是一种记录完备的用于替换上颌前部缺失牙的手术方法。这项回顾性研究旨在评估前磨牙自体移植到上颌前部后的长期存活率、成功率以及美学效果和患者报告的结果，其次是确定存活、成功、美学和生物学并发症的潜在预后因素。
对122例患者的153颗移植牙进行存活率和潜在预后因素评估，同时对50例患者的61颗自体移植前磨牙进行临床、影像学和美学评估。记录临床和影像学参数。使用综合评分系统将移植牙与相邻牙齿进行比较来评估美学效果。所有患者填写一份关于治疗美学效果的问卷。
16至38年后移植牙的存活率为76%，大多数无牙周并发症（95%）。影像学检查显示，46%的移植前磨牙无病变迹象。分别观察到19%和16%的移植牙发生了牙根粘连和炎性吸收。供牙类型和牙根发育阶段等预后因素对移植牙的存活没有显著影响。与成熟度较高的移植牙相比，未成熟阶段移植的前磨牙发生牙根粘连的风险显著较低。在美学方面，72%的移植牙与相邻牙齿匹配，综合生物学成功情况，总体成功率为57.3%。总体而言，71%的患者对自体移植美学效果满意，18%的患者比较满意，11%的患者不满意。
移植牙显示出较高的存活率，尽管存在牙根粘连和炎性牙根吸收等生物学并发症。移植时牙根的发育阶段对移植牙的牙根粘连有显著影响。美学效果总体令人满意，尽管某些修复类型和供牙选择存在挑战。总体而言，大多数患者对自体移植牙表示满意。
