Humans ; Gingival Recession/surgery* ; Gingivoplasty/methods* ; Connective Tissue/transplantation* ; Treatment Outcome ; Gingiva/transplantation* ; Tooth Root

Cuspid ; Digital Technology ; Humans ; Maxilla ; Tooth Eruption, Ectopic ; Tooth, Impacted ; Transplantation, Autologous

Objective: To screen and analyze the factors affecting the prognosis of replacing single missing tooth by autograft tooth, so as to provide reference for clinical judgment of surgical prognosis. Methods: A total of 176 patients (188 teeth) underwent autotransplantation of teeth in the Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University from January 2017 to December 2019, including 85 teeth of males and 103 teeth of females were involved. The age was (33.0±9.8) years (16-65 years). The possible factors affecting the prognosis of replacing single missing tooth by autograft tooth were summarized and grouped, and the clinical and imaging data were recorded and judged. The surgical records and photographic data from the patients' previous medical records were retrospectively analyzed. The survival analysis method was used for statistical analysis to screen out the factors affecting the cumulative survival rate of transplanted teeth. Results: The 5-year cumulative survival rate of 188 transplanted teeth was 88.4%. Univariate Log-Rank analysis showed that age (P<0.001), sex (P=0.008), smoking (P<0.001), position of recipient area (P<0.001), height of alveolar bone in recipient area (P<0.001), time of donor tooth in vitro (P<0.001), use of donor model (P<0.001) and initial stability (P<0.001) were significantly correlated with cumulative survival rate of transplanted teeth. Multivariate Cox proportional hazard regression analysis showed that smoking (β=-2.812, P=0.049), alveolar bone height (β=1.521, P=0.020), donor time (β=-2.001, P=0.019), use of donor model (β=1.666, P=0.034) and initial stability (β=-1.417, P=0.033) were significantly correlated with the cumulative survival rate of transplanted teeth. Conclusions: The prognosis of autogenous tooth transplantation can be predicted by smoking, height of alveolar bone in recipient area, time of donor teeth in vitro, use of donor model and initial stability. Good prognosis of transplanted teeth can be obtained by using donor model during operation, reducing the time of donor teeth in vitro, taking effective methods to restore alveolar bone height, maintaining good initial stability, and good oral health education after operation.
Adult ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Tooth/transplantation* ; Tooth Loss ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

Odontoma is an asymptomatic slow-growing odontogenic tumor. It is usually found by chance in the maxilla or mandible on radiography, or when it deforms the adjacent teeth. It is commonly found in patients who are 30 years of age or younger. We report our encounter with an odontoma within a dentigerous cyst found incidentally in a 56-year-old man. He presented with abnormal fullness in the right infraorbital area of the cheek. During the evaluation of the mass, we incidentally detected the odontogenic tumor within a dentigerous cyst in the patient's maxilla. Under general anesthesia, complete surgical drainage of the infraorbital cystic mass was performed. Enucleation of the odontogenic tumor and a bone grafting from the iliac bone were also performed. The final diagnosis was odontoma. After 2 years of follow-up, there was no sign of recurrence of the tumor. In case of odontogenic tumors, even in old patients, it is important to suspect an odontoma. When odontoma accompanies a dentigerous cyst, surgical excisional biopsy should be performed to rule out malignancy. In case of a large bony defect after enucleation, autogenous bone grafting is essential for reconstruction.
Alveolar Bone Grafting ; Anesthesia, General ; Biopsy ; Bone Transplantation ; Cheek ; Dentigerous Cyst ; Diagnosis ; Drainage ; Follow-Up Studies ; Humans ; Mandible ; Maxilla ; Middle Aged ; Odontogenic Tumors ; Odontoma ; Radiography ; Recurrence ; Tooth

The teeth are highly differentiated chewing organs formed by the development of tooth germ tissue located in the jaw and consist of the enamel, dentin, cementum, pulp, and periodontal tissue. Moreover, the teeth have a complicated regulatory mechanism, special histologic origin, diverse structure, and important function in mastication, articulation, and aesthetics. These characteristics, to a certain extent, greatly complicate the research in tooth regeneration. Recently, new ideas for tooth and tissue regeneration have begun to appear with rapid developments in the theories and technologies in tissue engineering. Numerous types of stem cells have been isolated from dental tissue, such as dental pulp stem cells (DPSCs), stem cells isolated from human pulp of exfoliated deciduous teeth (SHED), periodontal ligament stem cells (PDLSCs), stem cells from apical papilla (SCAPs), and dental follicle cells (DFCs). All these cells can regenerate the tissue of tooth. This review outlines the cell types and strategies of stem cell therapy applied in tooth regeneration, in order to provide theoretical basis for clinical treatments.
Adult Stem Cells ; physiology ; Animals ; Cell Differentiation ; Humans ; Stem Cell Transplantation ; Tissue Engineering ; Tooth ; cytology ; growth & development ; physiology ; Wound Healing

Oral rehabilitation of a patient having severe periodontitis with alveolar bone resorption and periodontal inflammation presents a challenge to clinicians. However, if appropriate implant placement according to the bone shape is selected, unnecessary bone grafting or soft tissue surgery can be minimized. In recent years, using cone beam CT and software, it has become possible to operate the planned position with the surgical guide made with 3D printing technology. This case was a 70 years old female patient who required total extraction of teeth due to severe periodontitis and performed a full-mouth rehabilitation with an implant-supported fixed prosthesis. During the surgery, the implant was placed in a flapless manner through a surgical guide. Immediate loading of the temporary prosthesis made by CAD/CAM method before surgery was done. Since then, we have produced customized abutments and zirconia prostheses, and have reported satisfactory aesthetic and functional recovery.
Bone Resorption ; Bone Transplantation ; Cone-Beam Computed Tomography ; Female ; Humans ; Inflammation ; Methods ; Mouth Rehabilitation ; Mouth ; Periodontitis ; Printing, Three-Dimensional ; Prostheses and Implants ; Rehabilitation ; Tooth

Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.
Autografts* ; Child ; Growth and Development ; Health Care Costs ; Humans ; Incidence ; Incisor ; Male ; Prognosis ; Tissue Donors ; Tooth ; Tooth Loss ; Transplantation ; Transplantation, Autologous*

PURPOSE: Although studies regarding dental developmental disturbances after childhood cancer treatment have increased, they have many limitations. Studies analyzing the significance of independent clinical risk factors with regard to the dental health status are also rare. We aimed to investigate the risk factors for dental developmental disturbances, particularly severe disturbances, in childhood cancer survivors (CCS). MATERIALS AND METHODS: Oral examinations and retrospective reviews of medical and panoramic radiographs were performed for 196 CCS (mean age, 15.6 years). Cancer type, age at diagnosis, treatment modality, type and accumulated dose of administered drugs, and dose and site of radiation were recorded. Dental developmental disturbances were diagnosed using panoramic radiographs and graded for severity according to the Modified Dental Defect Index (MDDI). Descriptive statistics and multivariate analyseswere performed to determine the association between dental abnormalities and clinical factors. RESULTS: In total, 109 CCS (55.6%) exhibited at least one dental anomaly, and the median value of MDDI was 2.5. Microdontia (30.6%) was the most prevalent anomaly, followed by tooth agenesis (20.4%), V-shaped roots (14.8%), and taurodontism (10.2%). Multivariate analysis revealed that a young age at diagnosis (≤ 3 years), a history of hematopoietic stem cell transplantation, the use of multiple classes of chemotherapeutic agents (≥ 4 classes), and the use of heavy metal agents were significant risk factors for severe dental disturbances. CONCLUSION: CCS with any of the above risk factors for severe developmental disturbances should be comprehensively followed up to minimize adverse consequences to their dental development and preserve their future dental health.
Diagnosis ; Diagnosis, Oral ; Hematopoietic Stem Cell Transplantation ; Humans ; Multivariate Analysis ; Odontogenesis ; Retrospective Studies ; Risk Factors* ; Survivors* ; Tooth ; Tooth Abnormalities

The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.
Animals ; Bone Regeneration* ; Bone Transplantation ; Cell Adhesion ; Dentin* ; Humans ; Immunohistochemistry ; Interleukin-6* ; Miners ; Osteocalcin ; Osteoclasts ; Osteosarcoma ; Rabbits ; Skull ; Tooth ; Transplants

Alveolar cleft is a tornado-shaped bone defect in the maxillary arch. The treatment goals for alveolar cleft are stabilization and provision of bone continuity to the maxillary arch, permitting support for tooth eruption, eliminating oronasal fistulas, providing an improved esthetic result, and improving speech. Treatment protocols vary in terms of the operative time, surgical techniques, and graft materials. Early approaches including boneless bone grafting (gingivoperiosteoplasty) and primary bone graft fell into disfavor because they impaired facial growth, and they remain controversial. Secondary bone graft (SBG) is not the most perfect method, but long-term follow-up has shown that the graft is absorbed to a lesser extent, does not impede facial growth, and supports other teeth. Accordingly, SBG in the mixed dentition phase (6–11 years) has become the preferred method of treatment. The most commonly used graft material is cancellous bone from the iliac crest. Recently, many researchers have investigated the use of allogeneic bone, artificial bone, and recombinant human bone morphogenetic protein, along with growth factors because of their ability to decrease donor-site morbidity. Further investigations of bone substitutes and additives will continue to be needed to increase their effectiveness and to reduce complications.
Alveolar Bone Grafting ; Bone Morphogenetic Proteins ; Bone Substitutes ; Bone Transplantation ; Clinical Protocols ; Dentition, Mixed ; Fistula ; Follow-Up Studies ; Humans ; Intercellular Signaling Peptides and Proteins ; Methods* ; Operative Time ; Tooth ; Tooth Eruption ; Transplants