Autogenous Tooth Transplantation Combined with Periodontal Regeneration and Orthodontic Treatment: A Case Report

Autotransplantation is an alternative treatment option for the reconstruction of an edentulous ridge. This procedure has been reported to have high success and survival rates. Here, we present the case of a 33-year-old woman who was referred to us from the orthodontic department to evaluate the scope for autotransplantation at the maxillary right first premolar, which had extensive large decay and a hopeless prognosis. There was severe bone destruction around the tooth and insufficient mesio-distal space. The treatment plan set by interdisciplinary cooperation included pre-surgical orthodontic treatment for space opening, autotransplantation of tooth 24 to site of tooth 14, simultaneous periodontal regeneration procedure, and post-surgical orthodontic therapy for space closure of tooth 24. Ideal wound healing was achieved 2 weeks after surgery, and the patient was recalled at a 3-month interval for follow-ups. At the 4-year follow-up, the transplanted tooth functioned well without concerning signs or symptoms. Radiographs showed a stable bone level and intact lamina dura around the transplanted tooth. However, lateral root resorption was observed, and it may be a complication of autotransplantation surgery. In conclusion, autotransplantation combined with periodontal regeneration and orthodontic therapy is a feasible approach. The present case showed ideal and stable clinical outcomes in the short-term period. However, prudent case selection and interdisciplinary integration are crucial in autotransplantation cases.

關鍵字

autotransplantation ； periodontal regeneration ； orthodontic force

並列摘要

自體齒移植是重建缺牙區的選項之一，且許多文獻記載其有良好的成功率及存活率。本文將討論33歲女性的臨床案例，由齒顎矯正科轉診評估右上顎第一小臼齒因深度齲齒建議拔除，且該牙位合併有牙周骨破壞和近遠心空間不足的問題。跨科討論擬定的治療計畫為：術前矯正做空間調整、由左上第一小臼齒自體移植至右上第一小臼齒、術中合併牙周再生治療、及術後的矯正治療。術後兩週時口內可見良好的傷口癒合，並請患者每三個月定期回診追蹤。術後四年回診時，該牙位功能正常且無任何臨床症狀，放射線影像呈現穩定的齒槽骨高度，然而遠心側有牙根吸收的現象。總結而言，在嚴謹案例選擇和詳細跨科治療計畫下，自體齒移植合併牙周再生和矯正治療為重建缺牙區可行的治療選項。

並列關鍵字

自體齒移植；牙周再生手術；矯正治療

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