ABSTRACT
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.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Prognosis , Retrospective Studies , Tooth/transplantation , Tooth Loss , Transplantation, Autologous , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To explore operative technique and clinical efficacy of tenotomy fixed on distal trochlea under arthroscopy for long head of biceps tendon and rotator cuff tear.</p><p><b>METHODS</b>From June 2015 to November 2016, 23 patients with long head of biceps tendon and rotator cuff tear were treated with tenotomy fixed on distal trochlea under arthroscopy and rotator cuff repair. Among them, including 9 males and 14 females aged from 44 to 71 years old with an average of(56.38±5.74) years old, 3 patients on left shoulder injury, and the other 20 patients on right shoulder injury. Constant-Murley shoulder score, VAS score and improvement of shoulder ROM were assessed before operation, 3 months, 6 months and 12 months after operation.</p><p><b>RESULTS</b>All patients were followed up from 12 to 18 months with an average of (15.37±4.82) months. Ipsilateral shoulder had no obvious pain, and ROM and muscle power almost returned to the level of patients' uninjured shoulder. Postoperative Constant-Murley score at 3 months was 67.47±12.19, 74.82±13.26 at 6 months after operation and 93.47±10.19 at 12 months after operation, which were better than that of 39.62±12.39 before operation. According to Constant-Murley score, 18 patients got excellent results, 4 good and 1 poor. There was statistical significance in VAS score before operation 6.85±2.14 and 0.36±0.54 at 12 months after operation. Anteflexion of shoulder joint and abduction at 12 months after operation were (163.55±15.24)°, (164.37±14.46)°, and improved more than before operation (75.52±6.31)°, (84.36±13.36)°.</p><p><b>CONCLUSIONS</b>Clinical effects of tenotomy fixed on distal trochlea under arthroscopy for long head of biceps tendon and rotator cuff tear were satisfied, solving pains of shoulder joint, recovering shoulder joint functions without damaging appearance and muscle strength of musculus biceps brachii.</p>