Let's talk about a new, but fairly confident area in medicine. This is a tooth transplant. This implies not only the implantation of artificial implants, but the transplantation of their own teeth (their rudiments). True, a startling discovery? The procedure is no longer innovative - it is available not only abroad, but also in Russia. We will determine its main varieties, indications and contraindications, the characteristics of the work carried out.
Types of transplants
First of all, tooth transplants are divided according to the age of the patient:
- Children and teens. The loss of large molars in young patients often leads to large-scale deformations of the jaw arch. Transplantation helps stop this pathogenic mechanism.
- Adults Loss of teeth not only leads to problems associated with chewing function, but also creates certain aesthetic inconveniences. Dental transplantation helps to cope with all these problems much more efficiently than removable dentures.
By variety, the operation is classified into several types:
- Autotransplantation.
- Allotransplantation.
- Dental implantation.
Each technique needs a separate presentation.
What is an autotransplant?
By this tooth transplantation is meant the transplantation of only uncut ones own. That is, such teeth that already have a formed crown, but do not have formed roots (in extreme cases, the initial stage of their formation is allowed). The graft moves to a new time with its own dental bag.
In what cases is such an operation possible? The method is used in case of loss / absence of the root. It is replaced by a tooth of wisdom.
I must say, the technique is not new in modern medicine: it was developed in detail in the middle of the last century by scientists Chudnovskaya N. A., Kozlov V. A.
Indications for surgery
Indications for tooth transplantation (we will list contraindications below) using this technique:
- Removal of a retined tooth. Modern orthodontics does not have the ability to bring it to the correct bite.
- Elimination of a defect in the dentition. If necessary, tooth extraction is selected as one of the measures of dental treatment.
- With complex anomalies of teething, when classical orthodontic and dental methods are powerless.
- There is an opportunity to transplant the wisdom tooth to the place of missing / lost molars - large and small.
Contraindications
Contraindications to tooth transplantation are limited to general and local bone tissue pathologies:
- Inflammatory processes affecting the jaw matter, the mucous membranes of the oral cavity.
- Tuberculosis.
- Acute and chronic endocrine, autoimmune and infectious diseases.
Operation
Here's how dental transplantation is done by specialists:
- The roots of the lost molar are removed. In its place, a receptive bed is prepared. The wound is treated with an antiseptic, and antibiotics are used.
- Extraction of an uncracked wisdom tooth along with its pouch. This is achieved by cutting out the outer wall of the jaw.
- The extracted tooth is immediately placed in the prepared bed.
- The graft is fixed with a mouthguard from a rapidly hardening mass with neighboring teeth.
Operation Results
What are the testimonials about dental transplantation? Both patients and specialists note that there is no likelihood of 100% engraftment. The main reason for this is that the size of the prepared fossa in the alveolus is larger than the volume of the new tooth. The way out of the situation is its freezing in a preserving liquid for 2-3 months in a special refrigerator.
It is noted that the success of the operation also depends on the type of fossa in the alveolus. If it is natural, then the forecasts are more favorable than in the case of artificial. In the latter type, tooth viability will not be too long.
Allotransplantation
Dental transplantation services in Moscow so far practically do not include proposals for a similar technique. It is distinguished by the possibility of transplanting tooth buds from a donor. However, in the world of practical interest in this experimenters, clinical doctors is huge. The methodology is based on the works of such scientists as Maksudov M.M., Kozlov V.A., Dranovsky G.E.
The basics of the method, which has already carried out experimental operations, are as follows:
- The most favorable period for transplantation is the time when the basic structures have already formed in the tooth germ. But so far without pronounced differentiation, as well as shaping.
- Both the taking of primordia from a donor and their transplantation to a needy patient occurs in strict adherence to aseptic rules.
- It is important to injure the transplanted material as little as possible.
- It is necessary to ensure close contact of the tissues of the tooth germ with the tissues of the gums of the new owner. The dense tooth fixation, ensuring its full nutrition is also important.
- Glue or blind seams are necessary to isolate the surviving dental primordia from infections that can spread in the oral cavity.
The need for allotransplantation
Dental transplantation in dentistry of this type is primarily indicated for young patients. For children and adolescents, it is necessary in the following cases:
- A child with a removable or constant bite does not have two or more adjacent teeth or their primordia. They may be removed / lost as a result of trauma, advanced caries or other dental disease. In this case, the alveolar bone should be in a normal state, not have destructive changes in itself.
- The absence of both large molars of the lower jaw and their rudiments. Loss can lead to a rapid pathological change in the alveolar process, to a lag in its development.
- Congenital adentia (complete absence of any teeth and their primordia).
All of the above leads to irreversible defects in the jaw arches, impaired growth and development of the alveolar processes, which modern orthodontics cannot fix in any other way. For a child or teenager, this is due to problems with speech, chewing function, inconveniences of an aesthetic plan.
Implant Classification
Dental transplantation in Israel, Russia and other countries, however, at the present stage of development rests on the implantation of implants. This is the most common artificial method for replacing lost / missing teeth, which in many respects bypasses the installation of bridges, removable dentures.
A common classification of implants is as follows:
- Interdental.
- Perineal
- Intraosseous.
- Subgingival.
- Combined.
Another gradation:
- Open. Penetrating through the epithelium.
- Closed. Fully covered by mesenchymal matter. For example, a magnetic implant.
Classification according to the shape of the implantable element:
- Cylindrical.
- Repeating the natural shape of the tooth root.
- Needle-shaped.
- Combined type (e.g., subperiosteal-intraosseous),
- Flat and so on.
The following division is according to the connection of the material of the implant with the bone tissue of the patient:
- Bone contact. These are materials such as carbon, ceramic based on alumina, titanium.
- Bone Compound This includes bioceramics, organic glass and so on.
- Covering the material with connective tissue. The group includes acrylates and polymers.
- Raman. The group may include all non-bioactive bases.
The following division - according to the main task of the implant to be installed:
- Supporting.
- Restraining.
- Designed for fixing other elements of the prosthesis, both removable and non-removable.
The last classification is according to the type of diligence to the anatomical structures of the patient:
- Subperiosteal. Such implants repeat the shape of the alveolar bone of the jaw on which they will be laid. Therefore, they are made strictly on a print that is obtained during the first operation. The implant itself is installed during the second surgical intervention. Such a product consists of an internal fixing part and an external supporting part.
- Intraosseous. Implants of this type are installed directly in the jawbone (subperiosteal will lie on the surface of the bone - they rest on it). Accordingly, the shape and size of the implants of this type determines the characteristic of the patient's bone tissue in the localization of implantation. In appearance they resemble cylinders, cogs, staples.
Indications for the installation of dental implants
An indication for such an operation is the patient’s desire to install an artificial crown in place of a removed, lost or missing tooth, which will be mounted on an artificial root. The operation is possible only if there is a pronounced alveolar ridge in the localization of the installation of a new tooth. The airways and jaw canals should be at a distance sufficient to accommodate the intraosseous implant.
Carrying out a similar tooth transplantation by a specialist (in Switzerland, Israel, Russia) is possible for all age groups. A special indication for patients with an unstable nervous system: before the procedure, they need to take sedatives for several days.
Contraindications to implantation
The main contraindication to the installation of artificial tooth root implants is the presence of systemic diseases and pathologies in the patient, which leads to a sluggish restoration of hard and soft tissues in the body.
The main contraindications to the procedure are as follows:
- Periodontitis.
- Systemic diseases of the hematopoietic system.
- Endocrine pathology.
- Tumor and tumor formations.
- Allergic reactions.
Dates of implantation
The very procedure of implanting an implant replacing the root of a natural tooth does not last long. As a rule, an experienced specialist will take only 30-40 minutes of time from his patient.
The recovery period lasts no more than a week. At this time, patients are shown certain hygienic procedures (rinsing the mouth with special solutions, decoctions of medicinal plants), taking analgesics. Already on the seventh day, the sutures are removed, control radiography is performed.
Implant implantation, which was considered innovative just literally yesterday, today is already the last century in orthodontics. He is being replaced by the transplantation of the rudiments of wisdom teeth - both their own and those provided by donors.