正畸加载对自体移植牙的牙周组织影响的Micro CT研究
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摘要
自体牙移植术(autotransplantation)是将自体牙完整摘出,再植于自身其他的缺牙部位。某些自体移植牙因受植区间隙不足或牙槽嵴宽度、高度不足等原因,需将供牙低于(牙合)平面或者旋转一定角度放置,因此,手术后需要应用正畸的方法对其进行扭正或近远中颊舌向的牵拉,或牙齿压低伸长的调整。这种因受到再植区条件限制而不能放置到正常位置的自体移植牙,后期是需要通过正畸治疗将其调整到正常位置的。即便自体移植牙的位置正常,临床上也常遇见牙弓内其它部位牙齿需要正畸移动的情况,此时,自体移植牙就需要被纳入矫治系统。近期有研究表明早期咀嚼刺激会减少骨粘连的发生率,并且提出通过正畸装置控制适宜的力值,对移植牙进行早期加载,会提高其移植后的成功率。
显微CT(Micro computed tomography,Micro CT)技术是一种新型的采用X线成像原理进行超高分辨率三维成像的设备,可以在不破坏样本的情况下,对骨骼,牙齿和各种生物材料进行超高分辨率X线成像,获得三维图像,并可以进行结构,密度和力学定量分析。本实验采用新型的Micro CT技术对正畸加载后的自体移植牙进行研究,描述正畸加载对自体移植牙牙周组织的影响,为提高自体移植牙的成功率提供参考。
【目的】
本研究构建动物模型,在移植后不同时程加载自体移植牙,并设置对照组,拍摄Micro CT,对牙齿及其周围牙周组织进行超高分辨率的X线成像,获得高精度三维图像,进行形态学观察,并对结构和密度进行定量分析,从而推断正畸加载对自体移植牙的牙周愈合的影响,为临床自体牙移植参考依据。
【方法】
选择8只健康成年雄性犬作为研究对象,犬龄均约为12月龄,体重在10-12kg。使用2%盐酸氯胺酮配合速眠新混合肌注麻醉后,进行牙齿的移植手术。选择两侧上颌中切牙进行实验,将牙齿拔出后对牙槽窝进行适当修整,将两牙齿交换植入对侧牙槽窝中,并与邻牙进行结扎固定。一周后拆除结扎固定装置并行常规根管治疗。在移植后的第一周,第四周,第八周及第十二周对左侧中切牙进行加载,力值为3oz。将右侧未加载的移植牙和未移植的加载支抗牙设为实验对照组,同时设立正常牙的空白对照组。在加载后一个月处死动物,获取所需牙齿及包括其周围牙周组织的骨块,拍摄Micro CT,利用数字化软件对牙齿及牙槽骨进行分析,并完成三维重建。比较不同时程加载的自体移植牙牙周组织预后的差异,以及实验组与对照组的牙周组织的差异性变化。
【结果】
1临床牙周状况检查
正畸加载与未加载的自体移植犬牙,在术后均未出现松动或者脱落现象。但根据术前及术后的牙周探诊检查发现,未正畸加载及正畸加载的移植牙其牙周袋都较术前加深,且牙龈附着较术前有一定程度的丧失,属于活动性位点,但未移植的牙齿加载后与正常牙齿的牙周状况变化不大,表明正畸加载对牙周组织的影响相对较小,而自体牙移植手术对牙周状况有一定的影响。
2 Micro CT检测
2.1形态结构的观察
自体移植牙拍摄Micro CT并进行三维重建后发现在自体牙移植术后第一周进行正畸加载的移植牙,在形态学上未见出现骨粘连,部分区域出现少量的牙根吸收,根尖区牙槽骨密度减低明显,骨小梁排列较紊乱;自体牙移植术后四周及八周进行正畸加载的移植牙,在形态学表现上无明显差异,未出现明显的骨粘连,牙根吸收少见,牙周膜间隙增宽不明显,根尖区牙槽骨密度减低不明显,骨小梁排列较均匀;自体牙移植术后十二周进行正畸加载的移植牙,牙周膜间隙变窄或消失,牙根部多区域发现骨粘连。设为对照组的未加载的自体移植牙,几乎未见牙根吸收的出现,但部分区域牙周膜间隙变窄甚至消失,可见骨小梁直接与牙骨质连接。对未移植的正常牙进行正畸加载一个月后未见明显牙根吸收,根尖区牙槽骨密度与正常牙无明显差别。
2.2骨结构参数比较
第一周加载的移植牙,其骨小梁数目(Trabecular number,Tb.N)最少,骨小梁间隙(Trabecular spacing,Tb.Sp)最大,即离散度最高,表明此时骨组织的重建最少。由骨体积分数(Bone Volume Fraction,BVF)及骨表面积体积比(Bonesurface/bone volume,BS/BV)量化结果可见,移植牙在第四周与第八周进行正畸加载其骨小梁体积占骨体积的比重较大,与正常牙及未加载的移植牙相差不大,说明第四到第八周时骨小梁重建基本完成,牙周骨组织恢复最好,牙槽骨组织部分重建;到第十二周Tb.N及Tb.Sp都有所下降,表明有骨粘连的发生。
通过各个骨结构参数比较发现,第四周开始进行正畸加载的移植牙根尖区5mm范围的“感兴趣区”(region of interest,ROI)其BVF,BS/BV,Tb.N三个参数值均在较高水平,且Tb.Sp值最低,提示根尖区骨小梁破坏最少,骨小梁离散度低。
【结论】
1.采用犬作为自体牙移植手术的动物模型是比较安全可靠的,可以得到较好的临床参考价值。
2.通过Micro CT观察可获得直观可靠的实验结果,并且推断在犬自体移植牙术后第四周到第八周进行正畸加载可以预防骨粘连的发生,并且没有发现显著增加牙根吸收发生的机率。
Autogenous tooth transplantation,or autotransplantation,is that the surgical transplant of a tooth from one location in the mouth to another in the same individual. Some auto-transplanted teeth might be placed lower than the occlusal plane or rotated when it couldn't be placed on the normal position.So the autotransplanted teeth must be adjusted by orthodontic treatment at the later stage.And when other teeth need to be corrected,it also would be included into the system.Recently,there are some research indicating that chewing stimulus in the early time will diminish the incidence of ankylosis.They presume that early load or control to the transplanted tooth by the orthodontic equipments will ensure the success of autotransplantation.
Micro-computed tomography(Micro CT) is a update technique which can achieve three dimensional X-ray photographs with high resolution that be carried out quantitative analysis to the structure,density and mechanics.It can finish to analysis bone,tooth and many kinds of biomaterial samples in nondestructive condition.The experiment described which influence the load would produce to the prognosis of the autotransplanted teeth by Micro-CT.This may provide information for increasing the achievement ratio of the autotransplanted teeth.
Objective
The study aimed to establish the animal model of autotransplantation teeth in dogs, and load the transplanted teeth of one side at different time,laying the teeth of the opposite side unloaded as the control group.Morphological observation,analysis structure of the density and mechanics quantitatively.We hope to find the influence of orthodontic load to transplanted teeth,and look for a clue to treat the autotransplanted teeth in clinic.
Methods
8 male dogs were selected to prepare the animal autotransplanted teeth model, whose ages were 12 months,and their weights were 10-12kg.Autogenous tooth transplantation was done after general anesthesia by intramuscular injection of 2% ketamine hydrochloride and Su mian xin.Maxillary central incisors were chosen for experiment.Teeth were extracted carefully,and then transplanted the tooth of one side to the opposite tooth socket which had been managed to fit the donor teeth.Ligated them with the adjacent teeth。Dismantled the fixed equipments and undertook conventional root canal therapy after one week.Loaded(3oz) the left transplanted teeth at the 1~(st),4~(th) and 8~(th) week respectively,and the right unloaded were as control. Killed the animal and the sample were scaned by Micro-CT after loading one month. Analyzed the correlated parameters and completed three-dimensional reconstruction. Compared the differences of periodontal healing,and concluded the influences of time of orthodontic load to the transplanted teeth.
Results
1 Periodontal examination
The autotransplanted teeth loaded and unloaded didn't appear cinch or disappear. But through the examination by probing,we found that the periodontal pocket of autotransplanted teeth loaded and unloaded all were deeper than pre-operation and loss of attachment also appeared in some level.But the periodontal condition of the normal teeth loaded or unloded were similar.That indicated autotransplantation had more influences than orthodontics tooth movement.
2 Micro CT detection
2.1 morphosis observation
The autotransplanted teeth were reconstructed in three dimension by Micro CT.We could find that there is no ankylosis,some parts had slight root resorption,the alveolar bone density decreased in the apical zone obviously,and trabecular pattern was disordered in the transplanted teeth loaded at the first week.The transplanted teeth loaded at the 4~(th) week had no significant differences morphologically with 8~(th) week.There were slight ankylosis and root resorption,and the periodontal membrane space didn't widen obviously.The alveolar bone density in the apical zone didn't decrease obviously,and the trabecular pattern was uniform.There were narrower periodontal membrane space and some ankylosis loaded at the 12~(th) week after transplantation.
There were almost no root resorption and narrower periodontal membrane space in unloaded transplanted teeth.We could see the conjunction of the bone trabecula and cement.
2.2 bone architecture quantization comparison
The parameter Tb.N was lowest and The Tb.Sp was highest in transplanted teeth loaded at the 1~(st) week.That indicated the bone reconstruction was least;The parameters BVF and BS / BV were bigger from the 4~(th) to the 8~(th) week after auto-transplantation,and there were little difference with normal teeth and transplanted teeth unloaded,which demonstrated the bone trabecular reconstruction had completed on the whole,and the healing of periodontal tissue were best;The parameters both Tb.N and Tb.Sp decreased in transplanted teeth loaded at 12~(th) week obviously,which showed there were some ankylosis.
Conclusions
1.It is safe and reliable that the animal model of the autotransplanted tooth using dogs.The animal model can provide a good clinical reference value.
2.We can conclude that the autotransplanted teeth loaded can prevent ankylosis and don't increase significant probability of root resorption from the 4~(th) to 8~(th) week.
显微CT(Micro computed tomography,Micro CT)技术是一种新型的采用X线成像原理进行超高分辨率三维成像的设备,可以在不破坏样本的情况下,对骨骼,牙齿和各种生物材料进行超高分辨率X线成像,获得三维图像,并可以进行结构,密度和力学定量分析。本实验采用新型的Micro CT技术对正畸加载后的自体移植牙进行研究,描述正畸加载对自体移植牙牙周组织的影响,为提高自体移植牙的成功率提供参考。
【目的】
本研究构建动物模型,在移植后不同时程加载自体移植牙,并设置对照组,拍摄Micro CT,对牙齿及其周围牙周组织进行超高分辨率的X线成像,获得高精度三维图像,进行形态学观察,并对结构和密度进行定量分析,从而推断正畸加载对自体移植牙的牙周愈合的影响,为临床自体牙移植参考依据。
【方法】
选择8只健康成年雄性犬作为研究对象,犬龄均约为12月龄,体重在10-12kg。使用2%盐酸氯胺酮配合速眠新混合肌注麻醉后,进行牙齿的移植手术。选择两侧上颌中切牙进行实验,将牙齿拔出后对牙槽窝进行适当修整,将两牙齿交换植入对侧牙槽窝中,并与邻牙进行结扎固定。一周后拆除结扎固定装置并行常规根管治疗。在移植后的第一周,第四周,第八周及第十二周对左侧中切牙进行加载,力值为3oz。将右侧未加载的移植牙和未移植的加载支抗牙设为实验对照组,同时设立正常牙的空白对照组。在加载后一个月处死动物,获取所需牙齿及包括其周围牙周组织的骨块,拍摄Micro CT,利用数字化软件对牙齿及牙槽骨进行分析,并完成三维重建。比较不同时程加载的自体移植牙牙周组织预后的差异,以及实验组与对照组的牙周组织的差异性变化。
【结果】
1临床牙周状况检查
正畸加载与未加载的自体移植犬牙,在术后均未出现松动或者脱落现象。但根据术前及术后的牙周探诊检查发现,未正畸加载及正畸加载的移植牙其牙周袋都较术前加深,且牙龈附着较术前有一定程度的丧失,属于活动性位点,但未移植的牙齿加载后与正常牙齿的牙周状况变化不大,表明正畸加载对牙周组织的影响相对较小,而自体牙移植手术对牙周状况有一定的影响。
2 Micro CT检测
2.1形态结构的观察
自体移植牙拍摄Micro CT并进行三维重建后发现在自体牙移植术后第一周进行正畸加载的移植牙,在形态学上未见出现骨粘连,部分区域出现少量的牙根吸收,根尖区牙槽骨密度减低明显,骨小梁排列较紊乱;自体牙移植术后四周及八周进行正畸加载的移植牙,在形态学表现上无明显差异,未出现明显的骨粘连,牙根吸收少见,牙周膜间隙增宽不明显,根尖区牙槽骨密度减低不明显,骨小梁排列较均匀;自体牙移植术后十二周进行正畸加载的移植牙,牙周膜间隙变窄或消失,牙根部多区域发现骨粘连。设为对照组的未加载的自体移植牙,几乎未见牙根吸收的出现,但部分区域牙周膜间隙变窄甚至消失,可见骨小梁直接与牙骨质连接。对未移植的正常牙进行正畸加载一个月后未见明显牙根吸收,根尖区牙槽骨密度与正常牙无明显差别。
2.2骨结构参数比较
第一周加载的移植牙,其骨小梁数目(Trabecular number,Tb.N)最少,骨小梁间隙(Trabecular spacing,Tb.Sp)最大,即离散度最高,表明此时骨组织的重建最少。由骨体积分数(Bone Volume Fraction,BVF)及骨表面积体积比(Bonesurface/bone volume,BS/BV)量化结果可见,移植牙在第四周与第八周进行正畸加载其骨小梁体积占骨体积的比重较大,与正常牙及未加载的移植牙相差不大,说明第四到第八周时骨小梁重建基本完成,牙周骨组织恢复最好,牙槽骨组织部分重建;到第十二周Tb.N及Tb.Sp都有所下降,表明有骨粘连的发生。
通过各个骨结构参数比较发现,第四周开始进行正畸加载的移植牙根尖区5mm范围的“感兴趣区”(region of interest,ROI)其BVF,BS/BV,Tb.N三个参数值均在较高水平,且Tb.Sp值最低,提示根尖区骨小梁破坏最少,骨小梁离散度低。
【结论】
1.采用犬作为自体牙移植手术的动物模型是比较安全可靠的,可以得到较好的临床参考价值。
2.通过Micro CT观察可获得直观可靠的实验结果,并且推断在犬自体移植牙术后第四周到第八周进行正畸加载可以预防骨粘连的发生,并且没有发现显著增加牙根吸收发生的机率。
Autogenous tooth transplantation,or autotransplantation,is that the surgical transplant of a tooth from one location in the mouth to another in the same individual. Some auto-transplanted teeth might be placed lower than the occlusal plane or rotated when it couldn't be placed on the normal position.So the autotransplanted teeth must be adjusted by orthodontic treatment at the later stage.And when other teeth need to be corrected,it also would be included into the system.Recently,there are some research indicating that chewing stimulus in the early time will diminish the incidence of ankylosis.They presume that early load or control to the transplanted tooth by the orthodontic equipments will ensure the success of autotransplantation.
Micro-computed tomography(Micro CT) is a update technique which can achieve three dimensional X-ray photographs with high resolution that be carried out quantitative analysis to the structure,density and mechanics.It can finish to analysis bone,tooth and many kinds of biomaterial samples in nondestructive condition.The experiment described which influence the load would produce to the prognosis of the autotransplanted teeth by Micro-CT.This may provide information for increasing the achievement ratio of the autotransplanted teeth.
Objective
The study aimed to establish the animal model of autotransplantation teeth in dogs, and load the transplanted teeth of one side at different time,laying the teeth of the opposite side unloaded as the control group.Morphological observation,analysis structure of the density and mechanics quantitatively.We hope to find the influence of orthodontic load to transplanted teeth,and look for a clue to treat the autotransplanted teeth in clinic.
Methods
8 male dogs were selected to prepare the animal autotransplanted teeth model, whose ages were 12 months,and their weights were 10-12kg.Autogenous tooth transplantation was done after general anesthesia by intramuscular injection of 2% ketamine hydrochloride and Su mian xin.Maxillary central incisors were chosen for experiment.Teeth were extracted carefully,and then transplanted the tooth of one side to the opposite tooth socket which had been managed to fit the donor teeth.Ligated them with the adjacent teeth。Dismantled the fixed equipments and undertook conventional root canal therapy after one week.Loaded(3oz) the left transplanted teeth at the 1~(st),4~(th) and 8~(th) week respectively,and the right unloaded were as control. Killed the animal and the sample were scaned by Micro-CT after loading one month. Analyzed the correlated parameters and completed three-dimensional reconstruction. Compared the differences of periodontal healing,and concluded the influences of time of orthodontic load to the transplanted teeth.
Results
1 Periodontal examination
The autotransplanted teeth loaded and unloaded didn't appear cinch or disappear. But through the examination by probing,we found that the periodontal pocket of autotransplanted teeth loaded and unloaded all were deeper than pre-operation and loss of attachment also appeared in some level.But the periodontal condition of the normal teeth loaded or unloded were similar.That indicated autotransplantation had more influences than orthodontics tooth movement.
2 Micro CT detection
2.1 morphosis observation
The autotransplanted teeth were reconstructed in three dimension by Micro CT.We could find that there is no ankylosis,some parts had slight root resorption,the alveolar bone density decreased in the apical zone obviously,and trabecular pattern was disordered in the transplanted teeth loaded at the first week.The transplanted teeth loaded at the 4~(th) week had no significant differences morphologically with 8~(th) week.There were slight ankylosis and root resorption,and the periodontal membrane space didn't widen obviously.The alveolar bone density in the apical zone didn't decrease obviously,and the trabecular pattern was uniform.There were narrower periodontal membrane space and some ankylosis loaded at the 12~(th) week after transplantation.
There were almost no root resorption and narrower periodontal membrane space in unloaded transplanted teeth.We could see the conjunction of the bone trabecula and cement.
2.2 bone architecture quantization comparison
The parameter Tb.N was lowest and The Tb.Sp was highest in transplanted teeth loaded at the 1~(st) week.That indicated the bone reconstruction was least;The parameters BVF and BS / BV were bigger from the 4~(th) to the 8~(th) week after auto-transplantation,and there were little difference with normal teeth and transplanted teeth unloaded,which demonstrated the bone trabecular reconstruction had completed on the whole,and the healing of periodontal tissue were best;The parameters both Tb.N and Tb.Sp decreased in transplanted teeth loaded at 12~(th) week obviously,which showed there were some ankylosis.
Conclusions
1.It is safe and reliable that the animal model of the autotransplanted tooth using dogs.The animal model can provide a good clinical reference value.
2.We can conclude that the autotransplanted teeth loaded can prevent ankylosis and don't increase significant probability of root resorption from the 4~(th) to 8~(th) week.
引文
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[15] Schwartz 0, Andreasen JO, Greve T. Cryopreservation before replantation of mature teeth in monkeys. Effect of preincubation,different freezing and equilibration rates and endodontic treatment upon periodontal healing. Int J Oral Surg, 1985, 14:350-361.
[16] Hurzeler MB, Quinones CR. Autotransplantation of a tooth using guided tissue regeneration. J Clin Periedontol, 1993,20: 545-548.
[17] Kim E, Jung JY, Cha IH. Evaluation of the prognosis and causes of failure in 182 cases of autogenous tooth transplantation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100: 112-119.
[18] Chai Y, Slavkin HC. Prospects for tooth regeneration in the 21st century: a perspective. Microsc Res Tech, 2003, 60:469-479.
[19] Kristerson L, Andreasen JO. Influence of root development on periodontal and pulpal healing after replantation of insicors in monkeys. Int J Oral Surg, 1984, 13:313-323
[20] Kristerson L. Autotransplantation of human premolars. A clinical and radiographic study of 100 teeth. Int J Oral Surg, 1985, 14: 200-213.
[21] Andreasen JO. Periedontal healing after replantation and autotransplantation of incisors in monkeys. Int J Oral Surg, 1981,10(1):54-61.
[22] Andreasen JO. Interrelation between alveolar bone and periodontal ligament repair after replantation of mature permanent incisors in monkeys.J Periodontal Res,1981,16:228-235.
[23]Andreasen JO.Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys,Int J Oral Surg,1981,10:43-53.
[24]Kristerson L,Andreasen JO.The effect of splinting upon periodontal and pulpal healing after autotransplantation of mature and immature permanent incisors in monkeys.Int J Oral Surg,1983,12:239-249.
[25]Bauss O,Schilke R,Fenske C,et al.Autotransplantation of immature third molars:influence of different splinting methods and fixation periods,Dent Traumatol,2002,18(6):322-328,
[26]Andreasen JO,Paulsen HU.Yu Z,et al.A long-term study of 370autotransplanted premolars.Part Ⅱ,Tooth survival and pulp healing subsequent to transplantation,Eur J Orthod,1990,12(1):14-24.
[27]Andreasen JO,Paulsen HU,Yu Z,et al.A long-term study of 370autotransplanted premolars PartⅠ Surgical procedures and standardized techniques for monitoring healing.Eur J Oxthed,1990,12(1):3-13.
[28]Eriksson RA,Albrektsson T.The effect of heat on bone regeneration:an experimental study in the rabbit using the bone growth chamber.J Oral Maxillofac Surg,1984,42(11):705-711.
[29]刘卫平,宋光保,周磊。种植技术在自体牙移植的临床应用研究。中国口腔种植学杂志,2006,11(1):33-36。
[30]Trope M,Friedman S.Periodontal healing of replanted dog teeth stored in ViaSpan,milk and Hank's balanced salt solution,Endod Dent Traumatol,1992,8(5):183-188.
[31]Bauss O,Schwestka-Pollv R,et al.Effect of different splinting methods and fixation periods on root development of autotransplanted immature third molars,J Oral Maxillofac Surg,2005,63(3):304-10.
[32]邓娜。可使正畸牙齿移动的最适矫治力范围----一个数学模式的建立[J]。国外医学口腔医学分册,2005,32(5):332。
[33]Paulsen HU,Andreasen JO,Schwartz O.Pulp and periodontal healing,root development and root resorption subsequent to transplantation and orthodontic rotation:a long-term study of autotransplanted premolars,Am J Orthod Dentofacial Orthop,1995,108(6):630-40.
[34]Mine K,Kanno Z,Muramoto T,et al.Occlusal forces promote periodontal healing of transplanted teeth and prevent dentoalveolar ankylosis:an experimental study in rats.Angle Orthed,2005,75(4):637-644.
[35]刘伟涛。自体移植牙的正畸治疗及临床评价研究。北京大学硕士学位论文,2006。
[36]Hubsch R,Hansen LS.A histopathologic study of extraction wounds in dogs[J].Oral Surg Oral Med Oral Pathol,1969,28(2):187-196.
[37]Amler MR.The time sequence of tissue regeneration in human extraction wounds[J].Oral Surg Oral Med Oral Pathol,1969,27(3):309-18.
[38]许宋峰,王臻。Micro-CT在骨科的应用和进展。中国骨肿瘤骨病,2004,3(4):236-241。
[39]王疆,倪龙兴,艾林等。结合Micro-CT技术的上颌第一前磨牙三维模型的建立。实用放射学杂志,2006,22(5):535-536。
[40]Fan B,Cheung GS,Fan M,et al.C-shaped canal system in mandibular second molars:Part Ⅰ.Anatomical features.J Endod,2004,30(12):899-903.
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[42]Min Y,Fan B,Cheung GS,et al.C-shaped canal system in mandibular second molars Part Ill:The morphology of the pulp chamber floor.J Endod,2006,32(12):1155-1159.
[43]Man nocei F,Peru M,Sherrif M,et al.The isthmuses of the mesial root of mandibular molars:a micro-computed tomo-graphic study[J].Int Endod J,2005,38(8):558-563.
[44]Cheung GSP,Yang J,Fan B.Morphometric study of the apical anatomy of C-shaped root canal systems in mandibular second molars[J].Int Endod J,2007,40(4):239-246.
[45]Verna C,Dalstra M,Melsen B.The rate and the type of orthodontic tooth movement are influenced by bone turnover in a rat model[J].Eur J Orthod,2000,22:343-352.
[46]Trommel MF,KroonHM,Bloem JL,et al.MR imaging based strategies in limb salvage surgery for osteosarcoma of the Distal femur.Skeletal Radiol,1997,26(11):636-641.
[47]Borah B,Gross GJ,Dufresne TE,et al.Three-dimensional microimaging (MR micro and micro CT),finite element modeling and rapid prototyping provide unique insights into bone architecture in osteoporosis.Anat Rec,2001,265:101-110.
[48]Gross GJ,Dufresne TE,Smith T,et al.Bone architecture and image synthesis.Morphologie,1999,83:21-24.
[49]Bauss O,Schwestka-Polly R,Kiliaridis S.Influence of orthodontic derotation and extrusion on pulpal and periodontal condition of autotransplanted immature third molars,Am J Orthod Dentofacial Orthop 2004,125:488-96.
[50]马春敏,段银钟,李德华。自体牙移植在正畸临床上的应用。国外医学口腔医学分册,2004,31(1):77-79。
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[12]Schulz S.The prognosis of autologous tooth transplants in orthodontic treatment planning. Fortschr Kieferorthop, 1989,50:186-95
[13] Nethander G, Andersson JE, Hirsch JM. Autogenous free tooth transplantation in man by a 2-stage operation technique a longitudinal intra-individual radiographic assessment. Int J Oral Maxillofac Surg, 1988, 17:330-336.
[14] Schwartz 0, Andreasen JO. Cryopreservation of mature teeth before replantation in monkeys(I). Effect of different cryoprotective agents and freezing devices. Int J Oral Surg, 1983, 12(6):425-436.
[15] Schwartz 0, Andreasen JO, Greve T. Cryopreservation before replantation of mature teeth in monkeys. Effect of preincubation,different freezing and equilibration rates and endodontic treatment upon periodontal healing. Int J Oral Surg, 1985, 14:350-361.
[16] Hurzeler MB, Quinones CR. Autotransplantation of a tooth using guided tissue regeneration. J Clin Periedontol, 1993,20: 545-548.
[17] Kim E, Jung JY, Cha IH. Evaluation of the prognosis and causes of failure in 182 cases of autogenous tooth transplantation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100: 112-119.
[18] Chai Y, Slavkin HC. Prospects for tooth regeneration in the 21st century: a perspective. Microsc Res Tech, 2003, 60:469-479.
[19] Kristerson L, Andreasen JO. Influence of root development on periodontal and pulpal healing after replantation of insicors in monkeys. Int J Oral Surg, 1984, 13:313-323
[20] Kristerson L. Autotransplantation of human premolars. A clinical and radiographic study of 100 teeth. Int J Oral Surg, 1985, 14: 200-213.
[21] Andreasen JO. Periedontal healing after replantation and autotransplantation of incisors in monkeys. Int J Oral Surg, 1981,10(1):54-61.
[22] Andreasen JO. Interrelation between alveolar bone and periodontal ligament repair after replantation of mature permanent incisors in monkeys.J Periodontal Res,1981,16:228-235.
[23]Andreasen JO.Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys,Int J Oral Surg,1981,10:43-53.
[24]Kristerson L,Andreasen JO.The effect of splinting upon periodontal and pulpal healing after autotransplantation of mature and immature permanent incisors in monkeys.Int J Oral Surg,1983,12:239-249.
[25]Bauss O,Schilke R,Fenske C,et al.Autotransplantation of immature third molars:influence of different splinting methods and fixation periods,Dent Traumatol,2002,18(6):322-328,
[26]Andreasen JO,Paulsen HU.Yu Z,et al.A long-term study of 370autotransplanted premolars.Part Ⅱ,Tooth survival and pulp healing subsequent to transplantation,Eur J Orthod,1990,12(1):14-24.
[27]Andreasen JO,Paulsen HU,Yu Z,et al.A long-term study of 370autotransplanted premolars PartⅠ Surgical procedures and standardized techniques for monitoring healing.Eur J Oxthed,1990,12(1):3-13.
[28]Eriksson RA,Albrektsson T.The effect of heat on bone regeneration:an experimental study in the rabbit using the bone growth chamber.J Oral Maxillofac Surg,1984,42(11):705-711.
[29]刘卫平,宋光保,周磊。种植技术在自体牙移植的临床应用研究。中国口腔种植学杂志,2006,11(1):33-36。
[30]Trope M,Friedman S.Periodontal healing of replanted dog teeth stored in ViaSpan,milk and Hank's balanced salt solution,Endod Dent Traumatol,1992,8(5):183-188.
[31]Bauss O,Schwestka-Pollv R,et al.Effect of different splinting methods and fixation periods on root development of autotransplanted immature third molars,J Oral Maxillofac Surg,2005,63(3):304-10.
[32]邓娜。可使正畸牙齿移动的最适矫治力范围----一个数学模式的建立[J]。国外医学口腔医学分册,2005,32(5):332。
[33]Paulsen HU,Andreasen JO,Schwartz O.Pulp and periodontal healing,root development and root resorption subsequent to transplantation and orthodontic rotation:a long-term study of autotransplanted premolars,Am J Orthod Dentofacial Orthop,1995,108(6):630-40.
[34]Mine K,Kanno Z,Muramoto T,et al.Occlusal forces promote periodontal healing of transplanted teeth and prevent dentoalveolar ankylosis:an experimental study in rats.Angle Orthed,2005,75(4):637-644.
[35]刘伟涛。自体移植牙的正畸治疗及临床评价研究。北京大学硕士学位论文,2006。
[36]Hubsch R,Hansen LS.A histopathologic study of extraction wounds in dogs[J].Oral Surg Oral Med Oral Pathol,1969,28(2):187-196.
[37]Amler MR.The time sequence of tissue regeneration in human extraction wounds[J].Oral Surg Oral Med Oral Pathol,1969,27(3):309-18.
[38]许宋峰,王臻。Micro-CT在骨科的应用和进展。中国骨肿瘤骨病,2004,3(4):236-241。
[39]王疆,倪龙兴,艾林等。结合Micro-CT技术的上颌第一前磨牙三维模型的建立。实用放射学杂志,2006,22(5):535-536。
[40]Fan B,Cheung GS,Fan M,et al.C-shaped canal system in mandibular second molars:Part Ⅰ.Anatomical features.J Endod,2004,30(12):899-903.
[41]Fan B,Cheung GS,Fan M,et al.C-shaped canal system in mandibular second molars:Part Ⅱ-Radiographic features.J Endod,2004,30(2):904-908.
[42]Min Y,Fan B,Cheung GS,et al.C-shaped canal system in mandibular second molars Part Ill:The morphology of the pulp chamber floor.J Endod,2006,32(12):1155-1159.
[43]Man nocei F,Peru M,Sherrif M,et al.The isthmuses of the mesial root of mandibular molars:a micro-computed tomo-graphic study[J].Int Endod J,2005,38(8):558-563.
[44]Cheung GSP,Yang J,Fan B.Morphometric study of the apical anatomy of C-shaped root canal systems in mandibular second molars[J].Int Endod J,2007,40(4):239-246.
[45]Verna C,Dalstra M,Melsen B.The rate and the type of orthodontic tooth movement are influenced by bone turnover in a rat model[J].Eur J Orthod,2000,22:343-352.
[46]Trommel MF,KroonHM,Bloem JL,et al.MR imaging based strategies in limb salvage surgery for osteosarcoma of the Distal femur.Skeletal Radiol,1997,26(11):636-641.
[47]Borah B,Gross GJ,Dufresne TE,et al.Three-dimensional microimaging (MR micro and micro CT),finite element modeling and rapid prototyping provide unique insights into bone architecture in osteoporosis.Anat Rec,2001,265:101-110.
[48]Gross GJ,Dufresne TE,Smith T,et al.Bone architecture and image synthesis.Morphologie,1999,83:21-24.
[49]Bauss O,Schwestka-Polly R,Kiliaridis S.Influence of orthodontic derotation and extrusion on pulpal and periodontal condition of autotransplanted immature third molars,Am J Orthod Dentofacial Orthop 2004,125:488-96.
[50]马春敏,段银钟,李德华。自体牙移植在正畸临床上的应用。国外医学口腔医学分册,2004,31(1):77-79。