自体牙移植术临床管理现状与展望OA

Autotransplantation of teeth(ATT)is a surgical technique that involves transplanting a non-functional tooth(donor tooth)within the oral cavity to an edentulous area(recipient site).This procedure not only demonstrates re-liable long-term success and survival rates but also possesses unique osteoinductive capacity and soft tissue preserva-tion advantages,making it particularly suitable for the restoration of dental defects in adolescents.However,ATT is highly technique-sensitive,and its successful implementation depends on the operator's comprehensive mastery of mul-tidisciplinary knowledge,including alveolar surgery,periodontology,endodontics,prosthodontics,and orthodontics,as well as the precise design and execution of personalized surgical plans.Preoperative systematic evaluation is required to assess the root development stage of the donor tooth,the bone volume condition of the recipient site,and the compat-ibility between the donor tooth and the recipient site.For teeth with an open apex,pulpal healing through revasculariza-tion is often achievable with a high success rate,whereas those with a closed apex typically require root canal treatment 2-4 weeks postoperatively to minimize complications.Utilizing cone beam computed tomography,intraoral scanning,and virtual surgical planning enables accurate assessment of donor-recipient matching and the design of the transplanta-tion plan.Intraoperatively,careful attention must be paid to minimizing tissue trauma through precise planning and gentle manipulation,strictly limiting the extra-oral time of the donor tooth to within 15 min,and maintaining the root surface moist at all times to protect the periodontal ligament and improve surgical outcomes.The application of tools,such as 3D-printed personalized surgical guides,donor tooth replicas,and customized osteotomes,has enhanced the pre-cision of socket preparation.Further,emerging technologies,such as dynamic navigation,surgical robotics,and artifi-cial intelligence,have also demonstrated promising potential in the field of ATT.