意向性牙再植术的临床应用进展

doi:10.13591/j.cnki.kqyx.2025.03.012

摘要/Abstract

摘要：

随着现代口腔医学技术的不断进步,意向性牙再植术成为治疗牙髓根尖周病、牙体硬组织疾病的有效治疗方法,并为保留单颗重度牙周破坏、龈下牙体组织缺损及颌骨囊肿累及的患牙提供了有效的治疗措施。该文就目前意向性牙再植术的应用范围、不同病因(以牙髓根尖周病与重度牙周破坏为例)患牙再植过程中的临床操作等作一综述,以期为临床应用提供参考。

关键词: 意向性牙再植术, 临床应用, 临床进展

Abstract:

With the continuous progress of modern stomatology technology, intentional tooth replantation has become an effective treatment method for pulp and periapical diseases, as well as dental hard tissue diseases. It also provides functional treatment measures for preserving single tooth with severe periodontal destruction, subgingival tooth tissue defects, and jaw-bone cysts. In this paper, we systematically reviewed the extension of clinical application scope of the intention replantation, the different clinical operation (including teeth with only pulpal and periapical disease or teeth with severe periodontal destruction) during tooth replantation to provide reference for clinical application.

Key words: intentional replantation, clinical application, clinical progress

中图分类号:

R781.05

张靖晨, 吴文治, 陈卓. 意向性牙再植术的临床应用进展[J]. 口腔医学, 2025, 45(3): 223-228.

ZHANG Jingchen, WU Wenzhi, CHEN Zhuo. Clinical application progress of intentional replantation[J]. Stomatology, 2025, 45(3): 223-228.

图/表 1

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因素	牙髓根尖周病患牙	单颗重度牙周破坏患牙
相同因素	微创拔牙,保留根面牙周膜细胞最大限度缩短体外操作时间选择合适的再植牙体外存储介质及温度视术后情况行再植牙夹板固定
不同因素
术前CBCT评估	精准了解患牙根管的形态、辨别牙体发育异常、根管侧壁穿孔等	了解术前术后牙槽骨的高度和宽度
牙槽窝的处理	轻柔地清理牙槽窝的顶端部分,避免碰触牙槽窝壁	彻底去除牙槽窝内的炎症组织,视情况可行GTR
再植牙的处理	亚甲蓝溶液等探查牙根表面病变;根尖切除;术中根尖倒预备及倒充填	抗生素溶液冲洗牙根表面;不建议根尖切除;建议术前行根管治疗
再植时机	即刻再植	即刻再植或延迟再植