- 期刊
自體齒移植軟硬組織處理的新手法－使用相似齒縮短自體齒移植手術時間
A Novel Technique of Soft and Hard Tissue Management in Autotransplantation-Clinical Application of an Analogue Tooth to Reduce Surgical Time
摘要
自體齒移植術（autotransplantation）為一古老且已熟知的牙周手術。近年來，由於人工植牙技術之普及與穩定，更使得許多醫師紛紛因為自體移植之不確定因素太高而選擇使用人工植牙。儘管如此，自體移植的最大優勢至今依然無法被植牙取代。因為保留了牙根的自然形態與牙周韌帶組織，使得移植後的保養維持與治療方式無異於自然牙齒；反觀人工植牙卻因為植體的螺紋形態及骨整合緊密，導致日後植體牙周治療保養不易，一旦發生問題往往預後不佳。本手術在牙科錐狀射束電腦斷層輔助之下，藉由術前精確的診斷與模擬，事先製作移植齒的相似齒，測試接收區的空間及方位，並嘗試使用接收區侵入根叉之角化牙齦上皮及結締組織做為自體移植時之牙根覆蓋，完成後再將移植齒拔起植入接收區，減短移植齒在口外的時間以增加牙周組織的存活的可行性。
並列摘要
Autotransplantation had been documented since the time of ancient Egypt. However, compared to the less technique-sensitive procedures involved in artificial implantology, autotransplantation has relatively higher variability in terms of its success rate. Nevertheless, it still retains its irreplaceable strength in that it preserves the periodontal tissue, which makes it much easier to maintain the implant and also provides better proprioception feedback than an artificial implant.Innovative ideas have been introduced to improve the predictability of autotransplantation surgery. Through the use of cone-beam computer tomography and an analogue tooth, the procedures used during the surgery have been made less variable and are now better controlled. After carefully extraction of the donor tooth, the extraoral exposure time of the autoimplant has now been successfully reduced to less than 10 minutes and, by using a furcation flap, the transplanted root surface is able to be covered successfully. The outcome of the complete surgical procedure of this novel method has become highly predictable after the introduction of cone-beam computer tomography and the use of an analogue tooth.