牙齒自體移植應用於合併矯正、正顎手術之缺牙區域的贋復治療－病例報告

Combined Autotransplantation with Orthodontic Treatment and Orthognathic Surgery for Rehabilitation of a Partially Edentulous area-case Report

阮柏凱(Po-Kai Juan) ； 陳玫秀(May-Show Chen) ； 蔡吉陽(Chi-Yang Tsai) ； 彭伯宇(Boa-Yue Peng)

《中華牙醫學雜誌（中文版）》 26卷1期 (2007/03) Pp. 69-77

https://doi.org/10.7106/CJD.200703.0069

摘要

隨著對牙周韌帶復原的研究應用於臨床，因而提高自體移植的成功率，也讓我們重拾對牙齒自體移植的興趣。雖然現今牙科植體日益蓬勃發展，但保有牙周韌帶的自體移植牙在很多狀況下仍舊是一個不錯的治療選擇。本文報告一位40歲的男性病例，主訴右下後方缺牙導致吃東西不便。口腔檢查發現，有許多蛀牙及不適合之固定假牙的存在。病患同時合併有前牙錯咬及骨骼性安格氏第三類咬合。針對病患的狀況，我們採取牙齒矯正治療合併正顎手術來矯治其前牙錯咬及戽斗的外觀。同時利用因正顎手術需要所拔除的左下第一小臼齒進行自體移植，藉此關閉右下顎牙弓因缺牙所產生的空隙，最後再進行假牙的贋復治療。經過六年的追蹤，病人咬合穩定，自體移植牙齒存活良好。因此，牙齒自體移植在適當的條件下，可作為解決局部缺牙的治療方式。

關鍵字

牙齒自體移植 ； 牙齒矯正 ； 根尖下截骨術

並列摘要

When research of healing of periodontal ligaments is applied to clinical procedures, the success rates of autotransplantations have increased, and eventually, autotransplantation has gained increasing attention. Although the application of dental implants has progressed at the present time, autotransplantation, which preserves the periodontal ligament, is still an attractive treatment option in many cases. Herein, we report a case of autotransplantation for rehabilitation of a partially edentulous status. This 40-year-old male suffered from inconvenience when eating due to the absence of the lower right first molar and second premolar. After an oral examination, multiple decayed teeth and ill-fitting fixed prostheses were revealed. Furthermore, the patient complained about his crescent profile because of an anterior crossbite and skeletal angle class Ⅲ jaw relationship. To correct the skeletal class Ⅲ situation, orthodontic treatment combined with orthognathic surgery was carried out. The lower left first premolar was extracted on account of the orthognathic therapy and transplanted to the lower right edentulous area in order to close the space. Finally, fixed prostheses were applied to the autotransplanted tooth to replace the ill-fitting restorations. The occlusal status was stable, and the autotransplanted tooth was functioning well after 6 years of follow-up. Taken together, autotransplantation provides an alternative solution for a partially edentulous space in certain situations.

並列關鍵字

autotransplantation ； orthodontics ； subapical osteotomy