- 期刊
利用第三大臼齒作為自體齒移植－兩個病例報告
Autotransplantation Using Third Molar - Two Cases Report
摘要
自體齒移植在臨床上常用來取代已不可保留之牙齒或用以重建缺牙的區域。通常以第三大臼齒作為移植齒之首選，受植區的狀況亦是重要考量因素。本篇報告兩個案例，第一例為34歲男性，因右下第一大臼齒垂直牙根斷裂而拔除患齒，並立即以左上第三大臼齒自體移植於此拔牙區；術後十三個月觀察顯示移植齒無明顯之搖動度或不適，移植齒周圍齒槽骨有再生跡象、牙根周圍無明顯之吸收。第二例為30歲男性，因右下第一大臼齒齒裂而拔除，並以右下第三大臼齒為移植齒。病患因位工作因素於兩個月後才至本科回診，發現近心牙根尖及遠心牙根尖有吸收的現象。利用長時間的氫氧化鈣作為齒內用藥，直到牙根吸收的現象漸趨穩定後進行根管充填。術後十二個月回診時，齒槽骨及牙周韌帶已經產生，無明顯的牙根吸收或粘連，顯示預後良好。本文兩個案例顯示自體齒移植若有恰當的牙髓治療介入，以及適切的植入深度，將會有不錯的預後。
並列摘要
Autotransplantation of teeth is used to replace the non-restorable or missing tooth. The third molar is usually as the first choice of the donor tooth, and the condition of recipient site is also an important consideration. In this article, we reported two autotransplantation cases with different intervention time of Endodontic therapy. The first case was a 34-year-old man with his lower right first molar diagnosed as vertical root fracture. The tooth was extracted and her upper left third molar was chosen as the donor tooth to transplant to this area. Endodontic treatment was started on the 12th day after the surgery. In thirteen months follow up, the mobility of transplanted tooth was within normal limitation, and patient did not complain any discomfort. Besides, there were regeneration signs around the alveolar bone, and no significant resorption of the root. The second case was a 30-year-old man with his lower right first molar diagnosed as cracked tooth. The tooth was extracted, and his right lower third molar was transplanted to the socket. In the case, the endodontic therapy was postponed till two months later due to his individual factor. The transplanted tooth showed external root resorption at mesial and distal root apexes. We used calcium hydroxide as the intracanal medication until the root resorption was ceased, then root canal filling was performed. In the twelve months follow up, the patient did not complain any discomfort, and there was no clinical symptom and signs. Based on these two cases, proper timing of root canal treatment should be performed essentially after autotransplantation to get the good prognosis.