Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지

IMPACTED PREMOLARS AND MOLARS ASSOCIATED WITH DENTIGEROUS CYSTS IN CHILDREN

어린이에서 함치성 낭과 연관된 매복 소구치와 대구치의 치료

  • Shin, Cha-Uk (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Young-Jae (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Jung-Wook (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Jang, Ki-Taek (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Lee, Sang-Hoon (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Kim, Chong-Chul (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University) ;
  • Hahn, Se-Hyun (Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University)
  • 신차욱 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 김영재 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 김정욱 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 장기택 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 이상훈 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 김종철 (서울대학교 치과대학 소아치과학교실 및 치학연구소) ;
  • 한세현 (서울대학교 치과대학 소아치과학교실 및 치학연구소)
  • Published : 2008.11.30
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Abstract

Tooth impaction is a frequently observed eruption anomaly in pediatric dental practice. Young patients with impacted or unerupted teeth have more prediction for dentigerous cyst formation. Dentigerous cyst presents radiographic features, unilocular or multilocular radioluscency. Cysts occur most frequently in the premolar region except third molar. Dentigerous cysts can grow to a considerable size, and large cysts may be associated with a painless expansion of the bone in the involved area. Extensive lesions may result in facial asymmetry, osseous destruction, root resorption of proximal teeth and displacement of associated tooth. The nature of the causative tooth influences the type of surgical treatment required for the dentigerous cyst. If the cyst is associated with a supernumerary or wisdom tooth, complete enucleation of the cyst along with extraction of tooth may be the first treatment choice. Otherwise, preservation of the associated teeth should be considered to prevent a young patient from psychological and mental trauma because of the loss of tooth. We should consider the degree of tooth displacement, osseous destruction and growth pattern of oromaxillofacial area when planning treatment. Thus a proper and logical treatment planning can help a proper growth and development of oromaxillofacial area and can save the patient from a psychological and mental trauma. This report describes 4 cases of the management of impacted premolars and molars associated with dentigerous cysts in children.

치아 매복은 어린이 환자 진료 시에 자주 관찰되는 맹출 장애이다. 어린 환자에서 매복된 치아가 존재하는 경우, 함치성 낭과 연관이 있을 가능성이 높다. 함치성 낭은 제3대구치를 제외하고는 상악 견치, 하악 소구치 부위에서 가장 호발하며, 점진적인 증식으로 악골이 팽윤되어 안모를 변화시키며, 주위 악골의 파괴와 치근의 흡수를 야기하거나 침범된 치아의 변위를 유발할 수 있으므로, 조기 진단과 적절한 치료가 무엇보다도 중요하다. 함치성 낭과 연관된 치아가 과잉치나 지치라면, 치아의 발거를 포함한 완전한 낭종 적출술이 적절한 치료라 할 수 있지만, 그렇지 않은 경우에는 환자의 심리적, 정신적 외상을 예방하기 위해 원인 치아의 보존이 고려되어야 할 것이다. 이뿐만 아니라, 치아의 변위 정도, 골 파괴 정도, 치근의 성숙도, 주위 치아와의 관계, 환자의 교합과 구강 악안면 영역의 성장 양상 등도 같이 고려되어야 할 것으로 생각된다. 본 증례에서는 위와 같은 사항들을 고려하여, 함치성 낭과 연관된 매복 소구치와 대구치를 낭종 적출술 후 공간 유지, 외과적 수술과 교정적 견인, 외과적 발거 후 교정적 배열 등의 방법을 통해 양호한 치료 결과를 얻었기에 보고하는 바이다.

Keywords

References

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