| Purpose:This study offers a retrospective investigation in 261 autotransplanted teeth to provide clinical references in the following aspects:1.Statistical interpretation and systematic analysis of 261 autotransplanted teeth(237 molar teeth,90.8%)in root canal treatment after clinical symptoms or radiographical changes appear.2.Comparative analysis of healing discrepancies between mandibular third molar ipsilateral autotransplantation,mandibular third molar contralateral autotransplantation,and maxillary third molar autotransplantation into mandibular sites,and evaluate the causes in failed cases.Methods:1.Retrospective analysis of 254 patients in 261 clinical autotransplanted teeth data,with the longest follow-up of 22 yrs,and the mean of 1.66 yr.Postoperative periodical check-ups and x-ray examinations were evaluated,cases with apical periodontitis,internal root resorption,and external root resorption were promptly endodontically treated;exfoliated teeth or extracted teeth are regarded as failed cases.2.Categorize 100 developed permanent teeth autotransplanted teeth with follow-up longer than 3 months into:mandibular third molar ipsilateral autotransplantation group(Group A),mandibular third molar contralateral autotransplantation group(Group B),and maxillary third molar autotransplantation into mandibular region group(Group C),and analyze the survival rate of each group.8 failed cases are collected in cause investigation.Results:1.12 failed autotransplanted teeth occured in 261 cases.119,100,65,39,27,13 teeth persisted after 6 months,1 year,2,years,3 years,5 years,and 10 years follow-up respectively,corresponding to98.4%,95.4%,90.9%,,90.9%,84.2%,84.2%survival rate.55 cases(21.1%)prevailed in radiographical lesions with 46 cases of apical periodontitis,while 43 cases(91.3%)symptoms appeared after 2 year;8 cases of external root resorption and 1 case of internal root resorption occurred on average of 2 years postoperatively.Young permanent teeth autotransplantation on 5-year survival rate is 91.7%,and 63.7%were without root canal treatment;developed permanent teeth autotransplantation 5-year survival rate is 82%,and 58%were not endodontically treated.2.Group A had 33 cases survived within the follow-up period and 7 failed cases,with the survival rate of 82.5%;group B had 43 cases survived within the follow-up period and 1 failed case,with the survival rate of 97.73%;group C had all 17 cases survived with the survival rate of 100%;The total mean survival rate were calculated to 92%.The healing discrepancies between group A to group B and group A to groupC had statistical significance(P<0.05),while group B and group C had no statistical significance(P>0.05).In 8 failed cases,5 cases(62.5%)occurred 1 year postoperatively,2-year,4-year,and-5 year check-up each had 1 failed case;62.5%(5 cases)were caused by lack of alveolar bone height in result of Ⅲ° tooth mobility;postoperative retention inadequacy,periodontitis,and severe apical periodontitis each caused 1 failed case.Conclusion:1.The overall survival rate is high;dental pulp revascularization may occur in developed permanent teeth autotransplantation,and favorable outcome can be achieved in close check-up even without root canal treatment.2.The failure rate of ipsilateral third molar autotransplantation is higher than contralateral third molar third molar transplantation and maxillary third molar autotransplantation into mandibular region group;the main causes of failed cases are lack of alveolar bone height,root resorption,and periodontits,raise of prevention should be noted. |
PDF Full Text Request