异位尖牙自体移植的5年临床效果研究

目的 对正畸牵引困难的异位尖牙,应用牙种植外科技术结合正畸治疗进行尖牙移植,评价其软组织美学及长期效果.方法 对9位患者10例正畸牵引困难的异位尖牙行移植术.其中,男性4名,女性5名;年龄13岁～37岁,平均19.8岁.尖牙埋伏阻生8例,异位萌出2例;上颌7例,下颌3例.术前正畸,调整受植牙区近远中间隙.应用牙种植技术预备受植床,骨引导再生技术修复骨缺损及稳定移植牙.术后正畸排齐牙列.定期随访.临床检查评价牙龈软组织美学、牙及牙周组织状态.影像学检查评价牙根、根周膜及硬骨板状况.结果 所有病例随访2年～9年,平均5.1年.牙龈软组织美学评分13.33±0.87.牙周袋深度均小于3 mm.牙髓电活力测试正常4例.影像学检杳显示,根周膜间隙正常及硬骨板连续7例,根周间隙模糊2例,牙根替代性吸收1例.结论 本研究提示,结合牙种植外科技术和正畸治疗的异位尖牙移植,为正畸牵引困难尖牙提供了美学效果和长期效果良好的治疗选择.

Abstract：

Objective To evaluate the esthetics and outcome of the ectopically positioned canines treated with autotransplantation and orthodontics. Methods Ten ectopic canines in 9 consecutive patients (4 female, 5 male; mean age 19. 8 years, range 13～37 years) were included.Eight of them were deeply impacted and two canines were ectopically erupted (7 maxillary and 3 mandibular canines). The space of recipient site was created orthodontically before surgery. The recipient socket was prepared with dental implant surgery system. After transplantation, bone defect was grafted with guided bone regeneration (GBR) technique. Postoperative orthodontic treatment was carried out. Patients were followed up every 6 months. The pink esthetic score was evaluated.Periodontal pocket depth was measured. Pulpal vitality was assessed. Periapical radiograph was taken to evaluate root resorption, periodontal space and lamina dura. Results The average follow-up period was 5. 1 years (range 2～9 years). The pink esthetic score was 13. 33±0. 87. All pocket depth was less than 3 mm. Radiographic examination showed uninterrupted periodontal space and lamina dura in 7 cases, unclear periodontal space in 2 cases and replacement resorption in 1 case. Conclusions Autotransplantation of the ectopically positioned canines with the combination of dental implant surgical techniques and orthodontics could be suggested as an esthetic and predictable treatment modality.

Autotransplantation of ectopically positioned canine: a 5 year follow-up study

Objective To evaluate the esthetics and outcome of the ectopically positioned canines treated with autotransplantation and orthodontics. Methods Ten ectopic canines in 9 consecutive patients (4 female, 5 male; mean age 19. 8 years, range 13～37 years) were included.Eight of them were deeply impacted and two canines were ectopically erupted (7 maxillary and 3 mandibular canines). The space of recipient site was created orthodontically before surgery. The recipient socket was prepared with dental implant surgery system. After transplantation, bone defect was grafted with guided bone regeneration (GBR) technique. Postoperative orthodontic treatment was carried out. Patients were followed up every 6 months. The pink esthetic score was evaluated.Periodontal pocket depth was measured. Pulpal vitality was assessed. Periapical radiograph was taken to evaluate root resorption, periodontal space and lamina dura. Results The average follow-up period was 5. 1 years (range 2～9 years). The pink esthetic score was 13. 33±0. 87. All pocket depth was less than 3 mm. Radiographic examination showed uninterrupted periodontal space and lamina dura in 7 cases, unclear periodontal space in 2 cases and replacement resorption in 1 case. Conclusions Autotransplantation of the ectopically positioned canines with the combination of dental implant surgical techniques and orthodontics could be suggested as an esthetic and predictable treatment modality.