Nishihara K
Department of Oral Surgery, Faculty of Medicine, University of Tokyo, Japan.
Biomed Mater Eng. 1994;4(3):161-70.
Transplanted and replanted autogenous teeth or implanted artificial roots become easily ankylotic. However, if adequate functional loads are applied to them continuously postop with proper fixation, ankylosis can be prevented. The author found this fact through studies on autogenous tooth replantation 20 years ago. Therefore, not only can tooth transplantation, replantation, and artificial root implantation be done successfully with adequate functional loads, but surgical orthodontics as well as plastic operation of jaw deformity can also benefit in the same way. This therapeutic method is called functional surgery. The ankylotic process can be more effectively prevented by applying bioceramic granules. Using these methods, (a) 30 vital teeth in 23 patients were transplanted or replanted. Follow-up duration was 6 to 96 months. (b) Artificial roots made of compact sintered hydroxyapatite (apatite) were implanted under the new concept of functional surgery. In all, 57 artificial roots in 19 patients were implanted and observed for over 5 years. (c) Masticatory skeletal deformities of the viscerocranium were treated with the new concept of functional surgery applying sintered apatite. For this purpose, artificial bone implantation or simple gnathoplasty, tooth transplantation, and artificial root implantation was carried out in 15 patients, after which mastication training was applied with concomitant corrections of function inclination, i.e., oral-perioral habits. In these clinical experiments, excellent favorable results were obtained. The following conclusion was obtained: Introducing the new concept of functional surgery using bioceramics, not only tooth transplantation, as well as artificial root therapeutics, but deformity of the jaw can be steadily treated.
自体牙移植、再植或人工牙根植入后很容易发生牙根粘连。然而，如果术后通过适当固定持续对其施加足够的功能负荷，就可以防止牙根粘连。作者在20年前通过对自体牙再植的研究发现了这一事实。因此，不仅牙齿移植、再植和人工牙根植入在有足够功能负荷的情况下可以成功进行，外科正畸以及颌骨畸形的整形手术也能以同样的方式受益。这种治疗方法称为功能性手术。应用生物陶瓷颗粒可以更有效地防止牙根粘连过程。采用这些方法，（a）对23例患者的30颗活牙进行了移植或再植。随访时间为6至96个月。（b）在功能性手术的新概念下植入了由致密烧结羟基磷灰石（磷灰石）制成的人工牙根。总共对19例患者植入了57颗人工牙根，并观察了5年以上。（c）采用应用烧结磷灰石的功能性手术新概念治疗面颅骨咀嚼性骨骼畸形。为此，对15例患者进行了人工骨植入或单纯颌骨成形术、牙齿移植和人工牙根植入，之后进行咀嚼训练并同时纠正功能倾斜，即口周习惯。在这些临床实验中，获得了极佳的良好效果。得出了以下结论：引入使用生物陶瓷的功能性手术新概念，不仅可以稳定地治疗牙齿移植以及人工牙根治疗，还可以治疗颌骨畸形。
