Analysis of prognosticative factors in autotransplantation of mature permanent teeth combined with extracorporeal apical surgery：A summary of 84 cases

doi:10.3877/cma.j.issn.1674-1366.2025.01.005

Abstract

Abstract:

Objective

The factors influencing the success rate of mature permanent tooth autotransplantation combined with external apical surgery were analyzed to provide reference for clinical judgment of success rate.

Methods

Patients who received autologous tooth transplantation of mature permanent teeth and combined external apical surgery in the Department of Oral Surgery of Stomatology，Hospital of the Fourth Military Medical University from June 2014 to May 2023 were included.The reasons for the external apical surgery were as follows.Firstly，the root apex of the donor tooth was broken passively during extraction.Secondly，the root apex of the donor tooth was too crooked to implant into the recipient area.The possible factors affecting the success rate were summarized and evaluated.Surgical records and photography data from patients' previous medical records，including 12 factors such as gender，age，root shape and donor location，were analyzed.Survival analysis was used for statistical analysis to screen out the factors affecting the cumulative success rate of transplanted teeth after external apical surgery.

Results

The cumulative five-year success rate of 84 transplanted teeth was 77.2%.Single factor Log-Rank analysis showed that the location of the receiving area（P=0.004），the alveolar bone height of the receiving area（P=0.002），the donor time（P=0.005）and the initial stability（P=0.001）were significantly correlated with the cumulative success rate of tooth transplantation after external apical surgery.Multivariate Cox proportional hazard regression analysis showed that the location of the receiving area（P=0.039）and the height of the alveolar bone in the receiving area（P=0.036）were significantly correlated with the success rate of transplantation after external apical surgery.

Conclusions

By reducing the intraoperative time，restoring the alveolar bone height，and ensuring good initial stability，high success rate can be achieved for mature permanent tooth autotransplantation after external apical surgery.

Key words: Autotranplantation of tooth, External apical surgery, Success rate, Survival analysis

Xia Yang, Yongqing Li, Yong Jiang, Ning Xu, Hanguo Wang, Guangjie Xu, Xiaoyong Hui, Yuanyuan Ma, Rui Hou. Analysis of prognosticative factors in autotransplantation of mature permanent teeth combined with extracorporeal apical surgery：A summary of 84 cases[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2025, 19(01): 33-40.

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References 21

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因素	移植牙数量（颗）	成功［颗（%）］	χ²值	P值
性别			1.66	0.198
男	42	34（81.0）
女	42	38（90.5）
年龄			3.65	0.056
≤35岁	48	38（79.2）
＞35岁	36	34（94.4）
牙根形态			0.19	0.662
单根或融合根	22	18（81.8）
分叉根	62	54（87.1）
供牙位置			1.41	0.234
上颌	24	20（83.3）
下颌	60	52（86.7）
牙槽骨高度			10.0	0.002
充足	52	50（96.2）
不足	32	22（68.8）
牙槽骨宽度			2.90	0.089
充足	70	62（88.6）
不足	14	10（71.4）
受牙区位置			8.18	0.004
上颌	32	24（75.0）
下颌	52	48（92.3）
手术时机			0.48	0.487
同期	42	34（81.0）
二期	42	38（90.5）
是否主动截根			0.17	0.701
是	22	18（81.8）
否	62	54（87.1）
供牙离体时间			7.72	0.005
≤15min	58	54（93.1）
＞15min	26	18（69.2）
初期稳定性			11.7	0.001
1级	58	56（96.6）
2级	28	16（61.5）
手术时间			2.04	0.154
≤45min	30	24（80.0）
＞45min	54	48（88.9）

因素	移植牙数量（颗）	成功［颗（%）］	χ²值	P值
性别			1.66	0.198
男	42	34（81.0）
女	42	38（90.5）
年龄			3.65	0.056
≤35岁	48	38（79.2）
＞35岁	36	34（94.4）
牙根形态			0.19	0.662
单根或融合根	22	18（81.8）
分叉根	62	54（87.1）
供牙位置			1.41	0.234
上颌	24	20（83.3）
下颌	60	52（86.7）
牙槽骨高度			10.0	0.002
充足	52	50（96.2）
不足	32	22（68.8）
牙槽骨宽度			2.90	0.089
充足	70	62（88.6）
不足	14	10（71.4）
受牙区位置			8.18	0.004
上颌	32	24（75.0）
下颌	52	48（92.3）
手术时机			0.48	0.487
同期	42	34（81.0）
二期	42	38（90.5）
是否主动截根			0.17	0.701
是	22	18（81.8）
否	62	54（87.1）
供牙离体时间			7.72	0.005
≤15min	58	54（93.1）
＞15min	26	18（69.2）
初期稳定性			11.7	0.001
1级	58	56（96.6）
2级	28	16（61.5）
手术时间			2.04	0.154
≤45min	30	24（80.0）
＞45min	54	48（88.9）

影响因素	参数估计值	标准误	Waldχ²值	自由度	P值	OR值	95%CI
年龄	0.831	0.963	0.746	1	0.388	2.30	0.348，15.160
受区位置	3.200	1.550	4.263	1	0.039	24.54	1.176，511.857
离体时间	-0.505	0.913	0.306	1	0.580	0.60	0.101，3.611
牙槽骨高度	2.741	1.304	4.419	1	0.036	15.50	1.204，199.614
初期稳定性	-1.050	1.031	1.038	1	0.308	0.35	0.046，2.639
牙槽骨宽度	-1.472	0.979	2.261	1	0.133	0.23	0.034，1.564
供牙位置	-1.846	1.212	2.320	1	0.128	0.16	0.015，1.698

影响因素	参数估计值	标准误	Waldχ²值	自由度	P值	OR值	95%CI
年龄	0.831	0.963	0.746	1	0.388	2.30	0.348，15.160
受区位置	3.200	1.550	4.263	1	0.039	24.54	1.176，511.857
离体时间	-0.505	0.913	0.306	1	0.580	0.60	0.101，3.611
牙槽骨高度	2.741	1.304	4.419	1	0.036	15.50	1.204，199.614
初期稳定性	-1.050	1.031	1.038	1	0.308	0.35	0.046，2.639
牙槽骨宽度	-1.472	0.979	2.261	1	0.133	0.23	0.034，1.564
供牙位置	-1.846	1.212	2.320	1	0.128	0.16	0.015，1.698

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