以骨性埋伏齒自體移植重建前上顎齒列－病例報告

Reconstruction of Anterior Maxillary Dentition with Autotransplantation of Bony Impacted Teeth-A Case Report

林涵威(Han-Wei Lin) ； 郭英雄(Ying-Shiung Kuo) ； 曾建福(Chien-Fu Tseng)

《臺灣口腔顎面外科學會雜誌》 24卷4期 (2013/12) Pp. 277-288

摘要

自體齒移植在臨床上常用來取代無法保留之牙齒或重建缺牙區域，雖然此臨床應用早在50年代就有文獻的探討，但當時對於整個治療過程與作用機制都不甚明瞭，成功率也不符期待，因此漸漸被臨床醫師從治療選擇中給排除。90年代開始，隨著牙科植體的蓬勃發展，衝擊了傳統的治療模式，造成醫師選擇自體齒移植的意願及治療個數更加減少。此病例報告從探討自體齒移植的臨床應用及相關研究出發，期望能提高醫師們選擇此治療方式的信心與意願。本文報告一位15歲男性，無任何全身系統性疾病，因上顎前方缺牙及埋伏齒由基層診所轉診至本院口腔顎面外科就診。經放射線及臨床檢查後發現，病息之右上顎正中門齒及左上顎犬齒為完全骨性理伏齒，右上顎側門齒為異位萌發合併水平阻生。針對此狀況，我們安排病患於全身麻醉下進行右上顎正中門齒、右上顎側門齒、左上顎犬齒及左上顎乳犬齒拔除，並於右上顎正中門齒、右上顎側門齒及左上顎犬齒處進行自體齒移植手術。此三顆移植齒在接受後續根管治療後，預後良好，擁有正常功能，目前仍於門診持續追蹤觀察中。自體齒移植在適當條件下，可提供除牙科植體及傳統贗復方法以外，重建前上顎齒列的另一選擇。

關鍵字

自體齒移植 ； 埋伏齒 ； 前上顎齒列重建

並列摘要

Autogenous tooth transplantation is usually used to replace the hopeless tooth or the edentulous area. According to the previous studies, the success rate of autogenous tooth transplantation was not predictable because of the difficulty in predicting root development after transplantation and dental root resorption. So this treatment modality is not widely accepted to clinical application. Nowadays most clinicians consider that the osseointegrated dental implant may be more predictable than autogenous tooth transplantation, therefore, autogenous tooth transplantation is gradually excluded from routine practices in most of clinicians. In this case, we used impacted maxillary canine and incisor to reconstruct anterior maxillary dentition. After a period of following time, the wound healing, periodontal condition, periapical status and occlusal function were all showed uneventful. Patient was also satisfied with the practice. If patient is not suitable for dental implant therapy or can not afford to it, we hope that autogenous tooth transplantation could be one of the treatment modalities in our daily practices.

並列關鍵字

Tooth autotransplantation ； autogenous tooth transplantation ； impacted tooth ； reconstruction of anterior maxillary dentition