自体牙移植术规范化操作流程中国专家共识

doi:10.19438/j.cjoms.2020.05.002

摘要/Abstract

摘要： 自体牙移植术是指将牙从一个位置移植到同一个体的另一位置的手术过程,常见的是将埋伏、阻生、错位或异位萌出牙转移到其他需要拔牙部位或缺牙部位的牙槽窝内,或手术制备的牙槽窝内。作为生物相容性最好的修复方式,自体牙移植可以用天然牙恢复牙列缺失、维持牙槽骨的骨量,恢复受牙区正常的牙周组织和牙本体感受,达到“变废为宝”的目的。目前国内外尚缺乏一个公认的、具有可操作性的自体牙移植术的规范化操作流程（包括适应证、禁忌证、术前检查、术前准备、手术步骤、术后治疗及医嘱等）。为了进一步规范自体牙移植术的临床应用,我们结合该领域专家的操作经验,制订了自体牙移植术的规范化操作流程,以期提高自体牙移植术的成功率。

关键词: 自体牙移植术, 规范化, 操作流程, 专家共识

Abstract: Autotransplantation of teeth refers to the surgical procedure of transplanting tooth from one position to another within the same individuals. This procedure usually involves transferring an impacted, embedded, dislocated or ectopically erupted tooth to an extraction site or a surgically prepared alveolar socket. As one of the most biocompatible oral rehabilitation approach, tooth autotransplantation can preserve alveolar bone volume, restore functioning periodontal tissue and its proprioception, and consequently achieve the purpose of 'turning waste into wealth'. At present, there hasn't been a universally accepted standardized operation process on tooth autotransplantation including its indications, contraindications, preoperative preparation, surgical steps, and postoperative treatment and orders. In order to standardize its clinical application to further increase success rate, in combination with Chinese experts' clinical experience, a consensus on standardized operation process of autotransplantation of teeth has been proposed in this article.

Key words: Autotransplantation of teeth, Standardization, Operation process, Expert consensus

中图分类号:

R782.1

中华口腔医学会牙及牙槽外科专业委员会. 自体牙移植术规范化操作流程中国专家共识[J]. 中国口腔颌面外科杂志, 2020, 18(5): 390-394.

Professional Committee of Teeth and Alveolar Surgery, Chinese Stomatological Association. Chinese expert consensus on standardized operation process of autotransplantation of teeth[J]. China J Oral Maxillofac Surg, 2020, 18(5): 390-394.

参考文献

[1] Tsukiboshi M.Autotransplantation of teeth[M]. Berlin: Quintessence Publishing, 2001.
[2] 侯锐. 自体牙移植术:自体牙移植术简介[J]. 中国实用口腔科杂志, 2013, 6(8): 449-452.
[3] 侯锐, 田磊. 自体牙移植术历史与展望[J]. 中国实用口腔科杂志, 2013, 6(8): 452-455.
[4] Apfel H.Autoplasty of enucleated prefunctional third molars[J]. J Oral Surg (Chic), 1950, 8(4): 289-296.
[5] Apfel H.Preliminary work in transplanting the third molar to the first molar position[J]. J Am Dent Assoc, 1954, 48(2): 143-150.
[6] Andreasen JO, Paulsen HU, Yu Z, et al.A long-term study of 370 autotransplanted premolars. Part I. Surgical procedures and standardized techniques for monitoring healing[J]. Eur J Orthod, 1990, 12(1):3-13.
[7] Andreasen JO, Paulsen HU, Yu Z, et al.A long-term study of 370 autotransplanted premolars. Part II. Tooth survival and pulp healing subsequent to transplantation[J]. Eur J Orthod, 1990, 12(1):14-24.
[8] Andreasen JO, Paulsen HU, Yu Z, et al.A long-term study of 370 autotransplanted premolars. Part III. Periodontal healing subsequent to transplantation[J]. Eur J Orthod,1990,12(1):25-37.
[9] Andreasen JO, Paulsen HU, Yu Z, et al.A long-term study of 370 autotransplanted premolars. Part IV. Root development subsequent to transplantation[J]. Eur J Orthod, 1990,12(1):38-50.
[10] 侯锐, 周宏志, 译. 自体牙移植术[M]. 北京: 人民军医出版社, 2013.
[11] 侯锐, 许广杰, 惠小勇, 等. 自体牙移植300例临床分析[J]. 中国口腔颌面外科杂志, 2018, 16(1): 25-28.
[12] Ong D, Itskovich Y, Dance G.Autotransplantation: a viable treatment option for adolescent patients with significantly compromised teeth[J]. Aust Dent J, 2016, 61(4): 396-407.
[13] Ylikontiola LP, Sándor GK.Autotransplantation donor tooth site harvesting using piezosurgery[J]. Ann Maxillofac Surg, 2016, 6(1): 75-77.
[14] Stange KM, Lindsten R, Bjerklin K.Autotransplantation of premolars to the maxillary incisor region: a long-term follow-up of 12-22 years[J]. Eur J Orthod, 2016, 38(5): 508-515.
[15] Rohof ECM, Kerdijk W, Jansma J, et al.Autotransplantation of teeth with incomplete root formation: a systematic review and meta-analysis[J]. Clin Oral Investig, 2018, 22(4): 1613-1624.
[16] Prato GP, Zuccati G, Clauser C.Commentary: A translational medicine approach to tooth transplantation[J]. J Periodontol, 2017, 88(6): 519-525.
[17] Machado LA, Do Nascimento RR, Ferreira DM, et al.Long-term prognosis of tooth autotransplantation: a systematic review and meta-analysis[J]. Int J Clin Oral Maxillofac Surg, 2016, 45(5): 610-617.
[18] Kim S, Shin SJ, Park JW, et al.Long-term stability of autotransplanted premolars as a substitute for molars in adults[J]. J Endod, 2016, 42(8): 1286-1290.
[19] Kafourou V, Tong HJ, Day P, et al.Outcomes and prognostic factors that influence the success of tooth autotransplantation in children and adolescents[J]. Dent Traumatol, 2017, 33(5): 393-399.
[20] He W, Tian K, Xie X, et al.Computer-aided autotransplantation of teeth with 3D printed surgical guides and arch bar: a preliminary experience[J]. Peer J, 2018, 6: e5939.
[21] Cousley RRJ, Gibbons A, Nayler J.A 3D printed surgical analogue to reduce donor tooth trauma during autotransplantation[J]. J Orthod, 2017, 44(4): 287-293.
[22] Jaiswara C, Srivastava VK, Dhiman N.Autotransplantation of a strange positioned impacted central incisor in a surgically prepared socket: A miracle esthetic concept[J]. Int J Clin Pediatr Dent, 2016, 9(3): 269-272.
[23] Zufía J, Abella F, Trebol I, et al.Autotransplantation of mandibular third molar with buccal cortical plate to replace vertically fractured mandibular second molar: a novel technique[J]. J Endod, 2017, 43(9): 1574-1578.
[24] Verweij JP, Jongkees FA, Anssari Moin D, et al.Autotransplantation of teeth using computer-aided rapid prototyping of a three-dimensional replica of the donor tooth: a systematic literature review[J]. Int J Oral Maxillofac Surg, 2017, 46(11): 1466-1474.
[25] van der Meer WJ, Jansma J, Delli K, et al. Computer-aided planning and surgical guiding system fabrication in premolar autotransplantation: a 12-month follow up[J]. Dent Traumatol, 2016, 32(4): 336-340.
[26] Strbac GD, Schnappauf A, Giannis K, et al.Guided autotransplantation of teeth: A novel method using virtually planned 3-dimensional templates[J]. J Endod, 2016, 42(12): 1844-1850.
[27] Yang S, Jung B, Pang N.Outcomes of autotransplanted teeth and prognostic factors: a 10-year retrospective study[J]. Clin Oral Investig, 2019, 23(1): 87-98.
[28] Michl I, Nolte D, Tschammler C, et al.Premolar autotransplantation in juvenile dentition: quantitative assessment of vertical bone and soft tissue growth[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017, 124(1): e1-e12.
[29] Jang Y, Choi YJ, Lee S, et al.Prognostic factors for clinical outcomes in autotransplantation of teeth with complete root formation: Survival analysis for up to 12 years[J]. J Endod, 2016, 42(2): 198-205.
[30] Kokai S, Kanno Z, Koike S, et al.Retrospective study of 100 autotransplanted teeth with complete root formation and subsequent orthodontic treatment[J]. Am J Orthod Dentofacial Orthop, 2015,148(6): 982-989.
[31] Strbac GD, Giannis K, Mittlböck M, et al.Survival rate of autotransplanted teeth after 5 years-A retrospective cohort study[J]. J Craniomaxillofac Surg, 2017, 45(8):1143-1149.
[32] Gilijamse M, Baart JA, Wolff J, et al.Tooth autotransplantation in the anterior maxilla and mandible: retrospective results in young patients[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 122(6): e187-e192.
[33] Khalil W, EzEldeen M, Van De Casteele E, et al. Validation of cone beam computed tomography-based tooth printing using different three-dimensional printing technologies[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2016, 121(3): 307-315.

相关文章 15

[1]	郑家伟, 王绪凯, 秦中平, 范新东, 李凯, 杨耀武, 霍然, 刘少华, 赵吉宏, 汪小勇, 周德凯, 刘学键. 口服普萘洛尔治疗婴幼儿血管瘤中国专家共识（2022版）[J]. 中国口腔颌面外科杂志, 2022, 20(4): 313-319.
[2]	刘冰, 何悦, 彭歆, 孙长伏, 韩正学, 吴煜农, 彭利伟, 赵熠, 陶谦, 韩新光, 李劲松, 苏彤, 李波, 张雷, 胡砚平, 陈传俊, 李一, 李铁军, 赵怡芳. 牙源性角化囊肿诊疗中国专家共识[J]. 中国口腔颌面外科杂志, 2022, 20(3): 209-218.
[3]	王育新, 王志勇, 王永功, 王慧明, 王丽珍, 田皞, 叶金海, 付坤, 阮敏, 孙长伏, 孙国文, 刘法昱, 许碧云, 后军, 刘冰, 刘亮, 陈永锋, 陈占伟, 肖灿, 李思毅, 李志勇, 李勇, 李楠, 张陈平, 张东升, 张胜, 张凯, 杨溪, 何巍, 苏彤, 季彤, 林李嵩, 罗瑞华, 赵志立, 胡勤刚, 唐瞻贵, 徐蔚嘉, 黄志权, 黄晓峰, 梁玉洁, 韩正学, 韩伟, 蒋灿华, 喻建军, 蔡志刚, 廖贵清, 廖圣恺, 蔡惠明, 魏建华. 吲哚菁绿荧光成像技术在口腔鳞癌治疗中的应用：中国专家共识[J]. 中国口腔颌面外科杂志, 2022, 20(1): 1-6.
[4]	郭伟, 任国欣, 孙沫逸, 孔蕴毅, 王丽珍, 步荣发, 冉炜, 唐瞻贵, 李龙江, 孟箭, 孙志军, 尚伟, 吕炯, 武和明, 张陈平, 何悦, 马旭辉, 宋浩, 鞠侯雨, 郑家伟, 龚忠诚, 杨凯, 张杰, 吴云腾. 中国人口腔黏膜黑色素瘤临床诊治专家共识[J]. 中国口腔颌面外科杂志, 2021, 19(6): 481-488.
[5]	夏亮, 赵正宜, 邹多宏, 杨驰, 张志愿. 基于袋状可吸收生物膜行上颌窦瘘软、硬组织同期修补术的临床应用及操作规范[J]. 中国口腔颌面外科杂志, 2021, 19(6): 489-493.
[6]	陈传俊, 陈伟良, 孙长伏, 何悦, 蒋灿华, 彭歆, 尚政军, 韩正学, 李劲松, 侯劲松, 林李嵩, 韩新光, 魏建华, 王志勇, 吴煜农, 郑家伟, 李龙江, 王慧明, 李祖兵, 郭传瑸, 杨驰, 石冰, 张志愿. 颏下岛状瓣修复口腔颌面部缺损专家共识[J]. 中国口腔颌面外科杂志, 2021, 19(5): 385-391.
[7]	邹多宏, 刘昌奎, 薛洋, 胡开进, 杨驰, 张志愿. 帐篷钉技术在牙槽骨修复与再生中的临床应用及操作规范[J]. 中国口腔颌面外科杂志, 2021, 19(1): 1-5.
[8]	何悦, 蒋灿华, 侯劲松, 王慧明, 彭歆, 刘冰, 李劲松, 郑磊, 徐中飞, 吴煜农, 胡镜宙, 秦兴军, 艾松涛, 周辉红, 李春洁, 张世周, 王军, 李晓光, 刘忠龙, 祝奉硕. 穿支皮瓣修复口腔颌面-头颈部缺损专家共识[J]. 中国口腔颌面外科杂志, 2020, 18(5): 385-389.
[9]	鞠侯雨, 郑家伟, 孙沫逸, 唐瞻贵, 杨道科, 冉炜, 步荣发, 尚伟, 孟箭, 武和明, 席庆, 杨凯, 王军, 邹建明, 吴云腾, 任国欣, 郭伟. 口腔颌面头颈部鳞癌超声热化疗中国专家共识[J]. 中国口腔颌面外科杂志, 2020, 18(3): 193-198.
[10]	惠小勇, 侯锐, 许广杰, 李志文, 杨霞, 周宏志, 张昊, 尚磊. 自体牙移植术前难度预判因素的筛选及分析[J]. 中国口腔颌面外科杂志, 2020, 18(2): 132-135.
[11]	唐瞻贵, 步荣发, 郭伟, 孙沫逸, 郑家伟, 彭歆, 张惠, 段小红, 姜虹, 王淼, 张铁军, 杨旭东, 杨凯, 喻建军, 罗志勇, 谢咏秋, 胡延佳, 王柏胜. 口腔医疗中恶性高热临床诊治中国专家共识[J]. 中国口腔颌面外科杂志, 2020, 18(1): 1-9.
[12]	蒋灿华, 翦新春, 张志愿, 郑家伟, 石冰, 刘彦普, 何悦, 彭歆, 尚政军, 韩新光, 刘蔚东, 莫洋, 郭峰, 程智刚, 陈传俊, 龚忠诚, 金武龙, 张世周, 袁荣涛, 严奉国, 李鹏程, 张胜, 高兴, 陈洁. 口腔颌面外科日间手术中国专家共识[J]. 中国口腔颌面外科杂志, 2019, 17(5): 385-390.
[13]	刘建华, 张志愿, 石冰, 郭传瑸, 孙坚, 王慧明, 孙长伏, 郑谦. 唇缺损局部组织瓣修复重建专家共识[J]. 中国口腔颌面外科杂志, 2019, 17(5): 391-396.
[14]	李克雷, 姚伟, 秦中平, 李凯, 郑家伟, 范新东, 马琳, 周德凯, 刘学键, 尉莉, 李丽, 邰茂众, 王金湖, 吉毅, 周玲, 黄海金, 高晓芸, 黄志见, 顾松, 杨合英. Kasabach-Merritt现象诊断与治疗中国专家共识[J]. 中国口腔颌面外科杂志, 2019, 17(2): 97-105.
[15]	杨凯, 郭伟, 孙沫逸, 郑家伟, 李龙江, 唐瞻贵, 任国欣, 陈丹, 吕晓强, 张杰, 韩正学, 席庆, 孙志军, 陈晓品, 张涛, 车宗刚, 冉炜, 孟箭, 黄桂林, 唐洪, 肖灿. 口腔鳞状细胞癌时辰化疗中国专家共识[J]. 中国口腔颌面外科杂志, 2019, 17(1): 7-12.