autologous tooth transplantation

  • 文章类型: Case Reports
    骨化性纤维瘤(COF)是一种间充质良性牙源性肿瘤,这可能导致阻生或异位恒牙。自体牙齿移植是一个手术过程,其中一颗牙齿从同一个人的一个位置移植到另一个位置。该方法能有效恢复患者的咀嚼和美观,在更换缺牙方面是可行的。本研究报告1例同期COF切除联合异位犬自体移植修复牙列缺损,有效促进骨骼连续性和稳定性的恢复,达到即时和长期的美学功能要求。
    Cemento-ossifying fibroma (COF) is a mesenchymal benign odontogenic tumor, which may lead to impacted or ectopic permanent teeth. Autotransplantation of teeth is a surgical process, in which a tooth is transplanted from one position to another in the same individual. This method can effectively restore the patient\'s mastication and aesthetics and is feasible in replacing missing teeth. This study reports a case of simultaneous COF resection combined with heterotopic canine autotransplantation to repair dentition defect, which effectively promotes the restoration of bone continuity and stability and achieves immediate and long-term aesthetic function requirements.
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  • 文章类型: Journal Article
    背景:这项回顾性研究旨在确定哪些患者-捐赠的牙齿-,收件人网站-,与外科手术相关的变量可能会影响牙齿自体移植的结果。
    方法:样本包括122例患者的128例自体移植。一次就诊的临床/影像学检查用于定义结果为成功,生存,或失败。单独分析潜在指标与生存或失败类别的关联,并通过多变量逻辑回归模型对混杂因素进行校正。
    结果:经过1至30.11年的随访期,71.8%的自体移植成功,而生存和失败组的发生率分别为14.1%,分组成功率/生存率达到85.9%。口外时间>15分钟和难以处理/放置是生存和失败类别的强/独立风险协变量(OR>1,P<0.05)。此外,供体牙齿的未萌出/部分萌出状态是生存的重要指标,虽然受体部位的骨骼水平不足,手术拔除,初始稳定性差,预防性抗生素的缺乏与失败独立相关(OR>1,P<0.05)。根形态和套节状态作为受体部位对存活组影响的修饰(P>0.05)。
    结论:根据本研究的结果,供体牙齿的未萌出/部分萌出状态,手术拔除,总的口外时间>15分钟,受体的骨骼水平不足,难以处理/放置的自体移植,初始稳定性差,在手术过程中缺乏预防性抗生素,由于自体移植对结果的有害影响,因此在进行自体移植时必须谨慎考虑。
    BACKGROUND: This retrospective study aimed to identify which patient-, donor tooth-, recipient site-, and surgical procedure-related variables may influence the outcome of tooth autotransplantation.
    METHODS: The sample included 128 autotransplants performed in 122 patients. Single-visit clinical/imaging examinations were used to define the outcome as successful, survival, or failure. The association of potential indicators with the survival or failure categories was analyzed individually and adjusted for confounders through multivariate logistic regression models.
    RESULTS: After a follow-up period of 1 to 30.11 years, success was achieved in 71.8% of autotransplants, whereas the survival and failure groups had rates of 14.1% each, and the grouped success/survival rate reached 85.9%. An extraoral time >15 minutes and difficult handling/placement were strong/independent risk covariates for survival and failure categories (odds ratio >1, P < .05). Additionally, unerupted/partially erupted status of the donor tooth was a significant indicator for survival, whereas deficient bone level at the recipient site, surgical extraction, poor initial stability, and lack of prophylactic antibiotics were independently linked to failure (odds ratio > 1, P < .05). The root morphology and socket status acted as modifiers of the effect of the recipient site location on the survival group (P > .05).
    CONCLUSIONS: Based on the results of this study, unerupted/partially erupted status of the donor tooth, surgical extraction, total extraoral time >15 minutes, deficient recipient\'s bone level, difficult handling/placement of the autotransplant, poor initial stability, and lack of prophylactic antibiotics during the surgical procedure must be considered with caution when performing autotransplantation because of their deleterious influence on the outcome.
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  • 文章类型: Journal Article
    背景:牙齿自体移植(DAT)是一种替代患者缺失或受损牙齿的生物学方法。这些技术通常需要多学科的方法。手术的预后和成功可能受到不同因素的不同程度影响。
    目的:评估DAT的结果和并发症,包括使用伞式综述的预后因素。
    方法:搜索了截至2022年6月30日发表的所有相关系统综述的六个数据库。语言或出版日期没有限制。
    方法:DAT研究的系统评价和荟萃分析。
    方法:鉴定,筛选,资格,和使用AMSTAR2工具的质量评估由两名作者(M.C.和S.A.)独立进行.两项研究(20%)得分中等,六项研究(60%)得分较低,两项研究(20%)得分极低。数据使用随机效应荟萃分析进行分析,并进行meta回归以研究开放和封闭顶点对因变量的影响.结果总结为相对风险比。
    结果:共有310项研究符合纳入条件,其中20项研究被选择用于全文评估。包括十项系统审查,其中9人进行了荟萃分析。总体研究结果表明,DAT提供了良好的成功率和生存率。Meta回归结果表明,闭合的顶点增加了强直和吸收的比例,在观察期间降低了生存率,但对成功率没有影响。
    结论:所有系统综述均存在不同程度的异质性和偏倚。系统评价中包括的供体牙齿样本在形态上也有所不同。
    结论:DAT是一种技术敏感的程序,需要多学科团队,警惕病例评估和彻底考虑各自涉及的预后因素。尽管研究中报道了方法学上的局限性,DAT显示出良好的成功率和存活率,具有骨诱导和软组织厚度保存的独特优势,并且应该,因此,被认为是一种可行的治疗方式。强烈建议临床指南和实践的标准化。
    背景:CRD42020202484。
    BACKGROUND: Dental autotransplantation (DAT) is a biological way of replacing missing or compromised teeth for patients. The techniques often necessitate a multi-disciplinary approach. The prognosis and success of the procedure may be impacted by variable factors in varying degrees.
    OBJECTIVE: Evaluating outcomes and complications of DAT, including prognostic factors using an umbrella review.
    METHODS: Six databases were searched for all relevant systematic reviews published up to 30 June 2022. No restrictions were applied to language or publication date.
    METHODS: Systematic reviews and meta-analyses of DAT studies.
    METHODS: Identification, screening, eligibility, and quality assessment using the AMSTAR 2 tool were performed independently by two authors (M.C. and S.A.). Two studies (20%) scored moderate, six studies (60%) scored low, and two studies (20%) scored critically low. Data were analysed using a random effects meta-analysis, and meta-regression was performed to investigate the effect of open and closed apices on the dependent variables. The results were summarised as relative risk ratios.
    RESULTS: A total of 310 studies were eligible for inclusion, of which 20 studies were selected for full-text evaluation. Ten systematic reviews were included, 9 of which had a meta-analysis. Overall findings suggest that DAT offers favourable success and survival rates. Meta-regression results indicate that a closed apex increased the proportion of ankylosis and resorption, reduced survival but had no effect on success during the observational period.
    CONCLUSIONS: A varying degree of heterogeneity and bias was present in all systematic reviews. The samples of donor teeth included in the systematic reviews also varied morphologically.
    CONCLUSIONS: DAT is a technique-sensitive procedure requiring a multidisciplinary team, vigilant case assessment and thorough consideration of the respective prognostic factors involved. Despite methodological limitations reported across studies, DAT shows favourable success and survival rates, with a distinctive advantage of bone induction and soft tissue thickness preservation, and should, therefore, be considered as a viable treatment modality. Standardisation of clinical guidelines and practice are highly recommended.
    BACKGROUND: CRD42020202484.
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  • DOI:
    文章类型: Journal Article
    OBJECTIVE: The production of individual tooth replicas has two applications in dental practice: tooth autotransplantations and dental root analogue implants. These applications require a particularly high degree of precision. The purpose of this study was to establish and evaluate a method for fabricating individual 3D-printed tooth replicas.
    METHODS: 10 patients requiring extraction of a wisdom tooth and a preoperative cone beam computed tomography (CBCT) scan were included; exclusion criteria were intraoperative fragmentation or fracture of the tooth. 3D Slicer 4.6.2 was used for tooth segmentation and model generation based on CBCT data. The tooth replicas were manufactured by selective laser melting (SLM). The extracted teeth and 3D-printed replicas were scanned and tested for surface deviations in CloudCompare 2.8.1.
    RESULTS: The mean absolute surface deviation between the 3D-printed teeth and the corresponding extracted teeth ranged from 0.13 to 0.25 mm, with standard deviations of 0.10 to 0.21 mm; 95% of the measured surface points deviated less than 0.474 mm; the surface area was reduced by -6.0% and the volume by -3.4%. The root mean square was 0.238 mm and the mean maximum absolute surface deviation was 0.927 mm. The SLM technique showed a high precision with a mean absolute deviation of 0.045 mm and a standard deviation of 0.04 mm.
    CONCLUSIONS: 3D-printed tooth replicas with a very high accuracy could be produced based on CBCT data. The described method is suitable for manufacturing tooth replicas for use in tooth autotransplantations or for fabricating root analogue implants.
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