拔牙同期自体牙即刻移植的临床研究

目的:探讨拔牙后自体牙即刻移植的方法和临床效果。方法:对临床上有自体牙移植条件和愿望的43例患者进行术前评估。将最终接受自体牙移植的31例患者随机分为根管治疗组、非根管治疗组、人工骨移植组、非人工骨移植骨组。随访6～30月,对比临床效果。结果:31例移植牙经随访6～30月,均获得稳定和满意的咀嚼功能,X线影像未发现牙根吸收。根管治疗与否对移植的预后没有显著影响(P>0.05)。人工骨(Bio-Oss)移植有利于移植牙的骨性愈合和早期稳定,并能减缓牙槽骨的吸收(P<0.05)。结论:拔牙后自体牙即刻移植是修复牙列缺损的可行方法。     

种植技术在自体牙移植的临床应用研究

目的:探讨牙种植技术在自体牙移植中的应用方法,评价其临床效果。方法:选择磨牙、前磨牙缺失17例及磨牙残根残冠行微创拔除19例,应用Frialit-2种植工具完成移植窝制备,拔除自体第三磨牙并植入移植窝,同期植入自体骨,托槽弓丝固定4周,固定期间进行移植牙根管治疗。结果:1例术后3月移植牙松动被拔除,35例(97.2%)术后随访1～7年,移植牙稳固,咀嚼功能正常,x线示移植牙与牙槽骨紧密贴合,牙根无吸收。结论:应用种植技术实施自体牙移植具有去骨精确,骨损伤小,成功率高的优点,临床效果肯定。     

牙根发育完全的牙在自体牙移植中的临床应用

目的:观察牙根发育完全牙的自体移植的临床效果。方法:50例51颗牙进行了自体牙移植。术前X线片对供体区牙牙体及受植区的间隙、骨量进行测量,局部麻醉下,先拔除受区患牙,清理并修整拔牙窝,随后拔出供体牙,试(牙合)就位后,拉拢缝合移植牙近远的颊舌侧中牙龈,形成软组织封闭,后牙采用缝线绕(牙合)面的"8"字固定1周,前牙树脂夹板固定3周,术后1周拆线,2-4周摘除牙髓,根管内Vitapex封药2-4周后行根管治疗,1、3、6个月复诊时进行临床和影像学检查。结果:经6个月至两年的随访,51颗牙中3例失访,1例因未作根管治疗至牙槽脓肿拔除,失败率7.84%;移植牙松动度减小在术后2-4周,4周后松动度进一步减小,至3个月后松动度相似文献   

埋伏牙或第三磨牙自体异位即刻移植的临床研究

目的：研究埋伏牙或第三磨牙即刻移植的临床效果及影响因素。方法：随机选取有先天性牙列缺损或有单个牙需要拔除同时具有骨性埋伏牙或第三磨牙的病人,对其行埋伏牙或第三磨牙自体异位即刻移植术,5年后观察其治疗效果,并研究患者年龄大小、性别差异对治疗效果的影响。结论：埋伏牙或第三磨牙自体异位移植技术已较成熟,青少年期性别和年龄差异对埋伏牙即刻移植治疗效果无明显影响,值得临床应用。     

局限性慢性根尖周炎对自体牙移植成功率影响的初步评价研究

目的:探究将第三磨牙同期移植至局限性慢性根尖周炎区,观察其临床疗效及成功率。方法:选取2021年2月～2022年2月就诊于新疆医科大学第一附属医院(附属口腔医院)口腔外科门诊行自体牙移植治疗的患者,分为实验组(局限性慢性根尖周炎)与对照组(根尖周无炎症),各18例。实验组受牙区彻底去除牙槽窝内病变组织后植入移植牙,对照组则直接植入移植牙。术后定期随访,术中记录供牙离体时间和试植次数,术后1周及1、3、6、12个月对移植牙进行临床和影像学检查,评估移植牙松动度及牙周组织愈合等。结果:两组移植牙术后即刻及术后1、4周移植牙松动度比较,差异均无统计学意义(P>0.05)。术后3个月,两组受牙区牙槽骨愈合率差异有统计学意义(P<0.05);术后6个月愈合率差异无统计学意义(P>0.05)。术后12个月,实验组1例发生牙根轻度外吸收,I度松动,治疗成功率为94.44%;对照组所有移植牙均达到成功标准,治疗成功率为100%;两组移植牙成功率差异无统计学意义(P>0.05)。结论:当受牙区患牙存在局限性慢性根尖周炎时,彻底去除病变组织后可考虑同期行自体牙移植。     

自体智齿移植9例临床效果观察

作者对9例自体下颌智齿移植到下颌第一磨牙病例进行了总结，经2～5年的临床随访现察，移植牙无松动，无脱落，牙周无明显炎症。经检查，牙根无吸收，呈牙周膜性愈合，行使咬功能良好．作者就手术适应征的选择、操作体会、疗效评价、愈合机制等进行了讨论。本组9例，3例为牙根尚未完全形成，6例牙根已形成。自体智齿移植虽取得初步成功，但远期效果有待进一步观察。     

种植义齿即刻修复的临床研究

目的 依据即刻修复种植理论，对种植固定义齿进行即刻修复以恢复美观和功能。方法 对单个牙缺失患者植入Replace螺旋型种植体后即刻修复，定期进行临床及X线片观察。结果 20枚种植义齿随访6～36个月，种植体无松动，X线片显示骨一种植体结合良好，种植体颈周骨吸收小于1．0mm。结论 单牙即刻修复近期临床观察效果满意。     

重度牙周病患牙拔除后即刻自身牙移植2年疗效与体会

目的观察重度牙周病患牙拔除后即刻自身牙移植的临床效果,分析影响临床效果的因素。方法9颗重度牙周病患牙经基础治疗后拔除,去除牙槽窝内的病变组织并以此处牙槽窝为受牙区。微创拔除患者自身第三磨牙(供牙),体外完成根管治疗和充填后植入已制备的牙槽窝内。根周骨腔植入拜阿蒙人工骨,缝合、结扎固定。术后随访观察2年的临床疗效。结果9颗重度牙周病患牙拔除后自身第三磨牙移植2年间除因松动拔除3颗外,其余6颗移植牙稳固、不松动,牙周无红肿,无可探入的牙周袋,可行使正常咀嚼功能。结论重度牙周病患牙拔除后即刻自身牙移植可取得较好的临床效果,去除病变组织、保持移植牙稳定和术后口腔卫生是影响疗效的主要因素。     

Bio-Oss在自体牙即刻移植中的临床疗效观察

目的：观察Bio—Oss在自体牙即刻移植中充填牙周骨缺损的临床效果。方法：17例17个移植牙，根据患者意愿分成治疗组6例和对照组11例，治疗组在移植牙根周骨缺损内充填Bio—Oss，随访6～12个月，对术后固定时间、松动度和影像学进行评价。对照组仅将移植牙植入牙槽窝内，牙根周缺损不充填任何填充剂。结果：Bio—Oss植入后，移植牙获得了早期的稳定，X线影像显示牙周膜影像消失，牙槽嵴高度降低不明显。对照组在固定时间、松动度、牙槽骨降低程度和骨下袋的发生率方面均高于治疗组。结论：在自体牙移植中植入Bio—Oss可促进牙周成骨，有利于移植牙的稳固。     

Bicon可吸收胶原塞在即拔即种牙中的临床应用

目的：观察Bicon可吸收胶原塞在即拔即种牙术中的临床疗效。方法：将16例患者19颗牙齿即刻拔除,即刻植入种植体,同时应用Bicon可吸收胶原塞覆盖于牙槽嵴顶封闭创1：2。术后当天、1周、1月、3月、6月及修复后每6个月行X线曲面断层片和临床检查,评价Bicon可吸收胶原塞在种植体周围引导骨组织再生修复的效果。结果：随访6。24个月,16例19枚即刻植入种植体除1枚1周后伤1：2裂开外,其余均稳固无松动,种植体周围无炎症及明显骨吸收,未出现X线透射影,临床修复效果好,种植体存活率达100％。结论：Bicon可吸收胶原塞生物相容性好,能促进骨缺损的再生修复,可成功地应用于即刻种植修复中。     

Evaluating success of autotransplantation of embedded/impacted third molars harvested using piezosurgery: a pilot study

Objective. To evaluate the success of autogenous transplantation of embedded/impacted third molars harvested using piezosurgery. Materials and methods. This prospective pilot study enrolled 20 healthy patients with non-restorable first/second molars and a caries-free retrievable embedded/impacted third molar. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth. Results. After an average follow-up of 16.4 months (SD = 1.9), 18 cases were successful with formation of periodontal ligament around the teeth. One tooth was lost due to infection at 1 month. One patient was lost to follow-up. There was no root resorption or ankylosis in any of the cases. In six donor teeth with complete root formation, root canal treatment was carried out. All the remaining teeth responded positively with vitality testing. Conclusion. Piezosurgery is an effective device if embedded/impacted third molars are to be harvested for successful autogenous transplantation.     

自体牙移植300例临床分析

目的: 评价自体牙移植的临床效果。方法: 选取近5年行传统自体牙移植治疗的患者300例,分别从性别、年龄、受牙区牙位、受牙患病或缺失情况、供牙牙位、手术类型、术中引导骨再生(GBR)、术后根管治疗（RCT）及随访情况等方面进行统计分析。结果: 共移植牙300颗,男120例,女180例;年龄17~62岁,平均（32±9.18）岁;上颌第一磨牙45例,上颌第二磨牙28例,下颌第一磨牙104例,下颌第二磨牙123例,下颌磨牙共占75.67%。残根74例,残冠116例,牙折35例,根尖周炎16例,牙根吸收19例,龋坏及底穿19例,长期缺失21例。供牙来自上颌第三磨牙142例,下颌第三磨牙158例。同期手术191例,二期手术109例。仅用高度浓缩生长因子血纤维蛋白（CGF）40例,用CGF复合骨充填材料64例,用正海生物膜复合骨充填材料2例,仅用骨充填材料5例。活髓未行根管治疗23例,术中逆向行根管治疗3例,术后行根管治疗274例。术后随访≥5年23例,4年10例,3年43例,2年111例,1年65例,6个月48例。总成功率为86.67%,存留率为96.67%,失败率为3.33%。结论: 自体牙移植术作为一种修复牙列缺损的理想方法,简单易行、快速有效,生物相容性最好,值得广泛推广。     

Autogenous transplantation of teeth with complete root formation: two case reports

AIM: Autotransplantation is an alternative treatment for replacing lost teeth when suitable donor teeth are available. This paper presents two cases of successful autogenous tooth transplantation. SUMMARY: Two third molars with complete root development were autogenously transplanted from their original sockets into new recipient sites on the same side of the mouth, one in the maxilla and one in the mandible. In both cases, the third molars were transplanted immediately after the first molar extractions. To provide better adaptation of the donor teeth, the recipient alveolar sites were remodelled using surgical burs. Semi-rigid splints were maintained for 45 and 15 days, respectively. Root canal treatment commenced one a week after transplantation and the canals were medicated with a calcium hydroxide paste before they were filled. Clinical and radiographic findings after 5 and 3 years of follow-up, respectively, are discussed in relation to the literature. KEY LEARNING POINTS: Autogenous transplantation of teeth with complete root formation may be considered as a viable treatment option to conventional prosthetic and implant rehabilitation for both therapeutic and economic reasons. Careful surgical and endodontic procedure, together with careful case selection may lead to satisfactory aesthetic and functional outcomes.     

14例正畸减数第一恒磨牙病例临床疗效分析及相关问题初探

目的 评价正畸减数第一磨牙的临床疗效,并就减数第一磨牙的相关矫治原则、间隙关闭情况及第三磨牙的建（牙合）等问题进行初步探讨.方法 选取我科近10年完成的14例减数第一磨牙矫治病例进行分析.通过对矫治前后模型的PAR指数和头颅侧位片,对矫治后磨牙间隙关闭、咬合关系及软组织侧貌进行评价;并通过曲面断层片,初步评价第二磨牙的牙根吸收和牙槽骨的改建以及第二磨牙和前磨牙的牙根平行状况.结果 14例患者平均疗程（29.5±4.3）个月,PAR疗效分析显示治疗后变差或无改变0例,改善5例,明显改善9例,提示拔牙间隙关闭满意,牙（牙合）关系良好;软组织侧貌协调,面型满意;曲面断层片显示第二前磨牙与第二磨牙牙根平行状况良好,第二磨牙牙根及牙槽骨无明显吸收.结论 减数第一磨牙病例只要严格把握适应证,合理的支抗设计和严谨的临床操作,可以获得满意的临床矫治效果.     

Wisdom Tooth Eruption Secondary to Localized Lower Molar Mesialization in Patients with Aplastic Lower Second Premolars

OBJECTIVE: After localized space closure in the mandible it is desirable to preserve lower wisdom teeth as natural replacements for missing second premolars and as antagonists for upper second molars. The aim of this study was to determine whether this treatment method can obviate the need for prosthodontic restorations, implants, and third molar osteotomy. Furthermore the time point of possible third molar eruption was to be determined and whether further orthodontic interventions were required to achieve their alignment. PATIENTS AND METHODS: The test group comprised 34 patients who exhibited agenesis of one or both lower second premolars (n = 45) in conjunction with a corresponding number of third molar tooth germs. Follow-up examinations were performed 2 to 8 years after conclusion of orthodontic treatment involving push-and-pull mechanics (PPM) without extraction of any contralateral teeth. The results of the clinical retrospective follow-up examination at consecutive post-treatment endpoints were compared with two orthodontic control groups (A: 4-premolar extraction group, B: non-extraction group). RESULTS: After an average of 4 years and 2 months, the percentage of fully-erupted third molars in the agenesis group with localized space closure was 82%, compared to 29% and 28%, respectively, in the controls. These differences were statistically significant (p < or = 0.01). The success rate in the agenesis group reached 94% when the 4- to 8-year results were considered in isolation. Compared with the contralateral (non-aplastic) side, teeth on the aplastic side erupted prematurely. In 9% of the cases, minor orthodontic interventions were required to exactly position the third molars. CONCLUSION: There is high probability that mandibular third molars can be preserved after localized space closure, obviating the need for prosthodontic restorations, dental implants, and third molar osteotomies.     

The unerupted maxillary second molar, due to an overlying and malformed upper third molar: treatment and follow-up

This retrospective study presents the treatment and follow-up of 20 young patients with 23 impacted upper second molars, due to overlying, impacted upper third molars. The third molars were removed surgically under local anaesthesia. After removal of these palatally obstructing teeth, radiographic and clinical follow-up was performed. The purpose of this study was to evaluate the eruption progress of the upper second molars after surgery. Radiological and/or clinical follow-up showed complete eruption of 19 (83%) of the upper second molars. For those cases treated before the age of 12 years and 4 months (the mean eruption age), all the upper second molars erupted completely. For those cases where surgical removal was undertaken after the mean eruption age, four (17%) of the upper second molars did not completely erupt. It was concluded that early treatment of impacted upper second molars, due to overlying third molars, may lead to more rapid eruption. Further prospective research is necessary to develop guidelines for the removal of palatally obstructing third molars to avoid eruption problems.     

Root and canal morphology of mandibular first and second molar teeth in a Jordanian population

Aim  To examine the root and canal morphology of mandibular permanent first and second molar teeth in a Jordanian population.
Methodology  A total of 685 extracted mandibular first and second permanent molar teeth were collected from dental clinics within north Jordan. The teeth were examined visually and the root number and morphology were recorded. After that, access cavities were prepared, pulp tissue dissolved by sodium hypochlorite and the root canals injected with Indian ink. Stained teeth were decalcified with 10% nitric acid, dehydrated with ascending concentrations of alcohol and rendered clear by immersion in methyl salicylate. The following observations were evaluated: (i) number of canals per root; (ii) number of root canals per tooth; (iii) canal configuration in each root; (iv) number and location of lateral canals and (v) presence of intercanal communications.
Results  Of 330 mandibular first molars, the majority had three (48%) or four (46%) canals, whilst 4% had a third disto-lingual root. Of 355 mandibular second molars, 58% had three canals, 19% two and 17% had four canals, whilst 10% had C-shaped roots. The most prevalent canal configuration in the mesial root of both first (53%) and second (40%) molars was type IV, and in distal roots was type I (54% in first and 79% in second molars).
Conclusions  Jordanian mandibular first and second molar teeth exhibit features close to the average Caucasian root and canal morphology.     

Effect of non-erupted third molars on roots of approximal teeth. A radiographic, clinical and histologic study

This study was undertaken to evaluate clinically and histologically root resorption in extracted human second molars in close proximity to non-erupted third molars. The control group consisted of extracted second molars that were proximal to fully erupted third molars. Eight out of the 11 teeth in the study group presented different degrees of radiographic root resorption nine presented clinical resorption, and all 11 had histologic evidence of root resorption. In the control group, no signs of root resorption were seen radiographically or clinically. Histologically, limited sites of resorption were identified in all teeth, which were partially repaired by cellular cementum. Histologic observation of study specimens revealed root surface resorption in 10 out of the 11 teeth, one showing replacement resorption as well. Inflammatory resorption was observed in the three most advanced cases in the study group. Reparative cementum partially lining resorbed areas was evident to all teeth with surface resorption. Within the limits of this study, radiographic identification of distal root resorption of second molars in close proximity to non-erupted third molars appears reliable. The findings may support the hypothesis that the presence of a non-erupted third molar in close proximity to the distal root of the second results in root resorption.     

Extraction of four second molars

The cases presented here clearly demonstrate that the removal of second permanent molars can be effective in many cases where removal of first or second bicuspids would otherwise be recommended. Third molars can be useful components of the dentition. The Author has found that when the proper diagnosis is made and the extraction of second molars is recommended, third molars will assume their position in juxtaposition to the first permanent molar in over 75% of the cases. Although we used several methods of measuring developing mandibular third molars, we were unable to predict accurately and consistently which teeth would erupt in the proper upright position (Fig. 10). With rare exception, maxillary third molars will erupt uneventfully, but in the mandibular arch there is a much greater possibility that it may be necessary to upright or reposition the third molars.