Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지

INTRAOSSEOUS TOOTH MIGRATION OF IMPACTED MESIODENS IN THE INVERTED POSITION

상악 정중부에 역위 매복된 과잉치의 악골 내 이동

  • Lee, Suk-Woo (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University) ;
  • Sohn, Hyung-Kyu (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry Yonsei University)
  • 이석우 (연세대학교 치과대학 소아치과학교실.구강과학연구소) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실.구강과학연구소) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실.구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실.구강과학연구소) ;
  • 손홍규 (연세대학교 치과대학 소아치과학교실.구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실.구강과학연구소)
  • Published : 2008.11.30
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Abstract

Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until $8{\sim}10$ years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla, surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during $6{\sim}7$ years of follow-up period since the first diagnosis had been made at the $2{\sim}3$ years of age.

과잉치는 상악 정중부에서 주로 발견되며, 과잉치의 발생 기전은 유전적 또는 환경적 원인에 의하여 치배 형성기 동안에 정상 치판의 비정상적 증식에 의한 것으로 보고되었다. 과잉치로 인한 합병증으로는 인접 영구치의 맹출 장애와 전위, 회전, 정중이개, 비강으로의 맹출, 낭종 형성 등 이 있다. 과잉치를 외과적으로 발거하기 위한 시기에 대해서는 논란이 되고 있다. 인접치의 배열과 맹출 장애, 전위를 야기할 수 있기 때문에 조기에 발거하자는 견해와 어린이의 행동 조절 및 인접 영구치의 치근 형성 정도를 고려하여 $8{\sim}10$세 이후에 발거 하자는 견해가 있다. 후자와 같이 외과적 발거 시기를 연기할 경우, 역위 및 수평 매복된 과잉치는 악골 내에서 비강 또는 경구개, 소구치 부위 등으로 이동할 수 있으며, 과잉치의 이동과 전상악골의 수직고경 증가로 인하여 외과적 발거 시 난이도가 높아질 수 있다. 따라서, 역위 및 수평 매복된 과잉치의 외과적 발거 시기를 결정하기 위하여 연기하는 경우에 과잉치의 악골 내 이동을 고려해야 한다. 이 증례는 상악 정중부에 역위 매복된 과잉치가 있어서 내원한 $6{\sim}7$세의 어린이에서 과잉치의 외과적 발거 시기를 결정하기 위하여 주기적인 방사선 학적 검사로 관찰하던 중에 $2{\sim}3$년 후 과잉치 위치가 악골 내에서 초진 시 위치로부터 이동된 경우로 이를 보고하는 바이다.

Keywords

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