THE DIAGNOSIS OF IMPACTED MAXILLARY MESIODENS USING 3-DIMENSIONAL COMPUTED TOMOGRAPHY : A CASE REPORT

3차원 전산화 단층촬영을 이용한 상악 정중 과잉치의 진단

The prevalence of the supernumerary tooth is $1{\sim}4%$. It usually occurs in the permanent dentition. It frequently occurs in the maxillary mid palatal area. The presence of the supernumerary tooth causes the following problems ; (1) interfering the eruption of successional tooth, (2) displacing the neighboring teeth, (3) resulting large diastema, (4) forming cystic change. So the supernumerary tooth should be removed as soon as possible. To extract the supernumerary tooth, the exact position must be noticed first. Radiographic techniques that were used in the past are tube shift technique, right angle technique, sterioradiography, using radiopaque contrast media and conventional tomography. But these methods include the subjective opinion of the operator. So, a technique eliminating the operator's opinion and showing the position 3-dimentionally can be used. 3-dimentional computed tomography equipped with dental softwares can show the position of the impacted supernumerally tooth in 3-dimentional position. It has an advantage to eliminate the subjective opinion of the operator. With a fast computer this techenique is done in a relatively short period of time. The rationale of this methods is relatively simple. After tacking X-ray and reconstructing the data 3-dimentionally, sequential removal of the soft tissue and hard tissue(bone) CT number leaves the teeth alone in 3-dimentional position. The image can be seen from anywhere, so the operator can see the image in front, rear, upper, and lower positions. In both cases 1 and 2, the position of the impacted supernumerary tooth is viewed by the 3-dimensional computed tomography. And it made the operator easy to figureout the exact position.

저자는 매복된 상악 정중 과잉치를 주소로 내원한 환아를 3차원 전산화 단층촬영술을 이용해 매복된 과잉치의 위치를 파악하였으며 다음의 결론을 얻었다. 1. 인접한 영구치에 대한 위해한 영향을 주지 않기 위해 상악 정중 매복 과잉치의 정확한 위치 판별이 요구된다. 2. 3차원 전산화 단층촬영법은 매복 과잉치의 위치판별에 있어서 객관적인 중요한 정보를 제공한다.