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[牙胚自体移植。3例治疗病例的讨论与展示]

[Auto-transplantation of tooth germs. Discussion and presentation of 3 treated cases].

作者信息

Massei G, Cardesi E

机构信息

Servizio di Anatomia Patologica, Ospedale Martini, Torino.

出版信息

Minerva Stomatol. 1997 Jul-Aug;46(7-8):407-14.

PMID:9297076
Abstract

The authors examine the theoretical possibilities of human dental transplants: autologous, homologous and heterologous. They, then discuss-with reference to autologous transplants-an autotransplant as an alternative to prosthodontic treatment. This would apply both to traditional prosthodontic treatment and on implants or orthodontic treatment aiming at filling dental gaps. They show both general and local counterindications against this operational method the knowledge of which is necessary for an adequate selection of patients. They stress the determining factors for a successful autotransplant: 1) particular care with the choice of the germ to be transplanted taking into account its morphology and the stage of root development; 2) adequate surgical preparation of the receiving site in relation to the size of the germ to be transplanted; 3) suitable surgical technique entailing a particular care in the manipulation of soft and hard tissues and of the germ and appropriate conditions of sterilization; 4) use of appropriate retention means to ensure stability of the transplanted germ so as to favour cellular proliferation and reduce osteoclastic activity; 5) reduction of occlusal pressure on the transplanted germ. The authors describe for example's sake 3 out of 32 cases treated with the documentation of the achieved long-term success. They also analyse the possible causes of failure of such operational method (careless manipulation of the germ, incorrect surgical technique, removal of the germ in a too early stage of its development, too long exposure of the germ outside the oral cavity, poor oral hygiene, caries, periodontal disease, occlusal trauma.

摘要

作者研究了人类牙齿移植的理论可能性

自体移植、同种异体移植和异种移植。然后,他们参照自体移植讨论了自体牙移植作为修复治疗替代方法的情况。这适用于传统的修复治疗以及旨在填补牙间隙的种植或正畸治疗。他们指出了这种手术方法的一般和局部禁忌证,了解这些对于充分选择患者是必要的。他们强调了自体牙移植成功的决定性因素:1)在选择要移植的牙胚时要特别小心,考虑其形态和牙根发育阶段;2)根据要移植牙胚的大小对受植部位进行充分的手术准备;3)合适的手术技术,在操作软组织、硬组织和牙胚时要特别小心,并要有适当的消毒条件;4)使用适当的固位方法以确保移植牙胚的稳定性,从而有利于细胞增殖并减少破骨细胞活性;5)减轻移植牙胚上的咬合压力。作者举例描述了32例治疗病例中的3例,并记录了取得的长期成功情况。他们还分析了这种手术方法失败的可能原因(对牙胚操作粗心、手术技术不正确、在牙胚发育的太早阶段将其拔除、牙胚在口腔外暴露时间过长、口腔卫生差、龋齿、牙周病、咬合创伤)。

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