대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제35권2호
  • /
  • Pages.305-312
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  • 2008
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  • 1226-8496(pISSN)
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  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지

외과적 정출술을 이용한 치관-치근 파절된 미성숙 영구치의 치험례

SURGICAL EXTRUSION OF THE CROWN-ROOT FRACTURED INCISORS: CASE REPORTS

  • 이은미 (경북대학교 치과대학 소아치과학교실) ;
  • 김태완 (경북대학교 치과대학 소아치과학교실) ;
  • 김현정 (경북대학교 치과대학 소아치과학교실) ;
  • 김영진 (경북대학교 치과대학 소아치과학교실) ;
  • 남순현 (경북대학교 치과대학 소아치과학교실)
  • Lee, Eun-Mi (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Tae-Wan (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Jung (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Young-Jin (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Nam, Sun-Hyun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
  • 발행 : 2008.05.30
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초록

치아의 치관-치근 파절은 치아파절이 치관과 치근에 걸쳐 발생되어 법랑질, 상아질 및 백악질까지 이환된 경우로 정의되며, 치수이환여부에 따라 복잡파절과 비복잡파절로 분류될 수 있다. 치관-치근 파절의 빈도는 유치열에서 2%, 영구치열에서 5%로 나타나며, 보통 상악 전치부에 호발한다. 이러한 치관-치근 파절된 치아의 수복을 위해서는 생물학적 폭경이 유지되어야 한다. 이를 위하여 사용되는 방법은 골삭제 후 치은절제술, 교정적 견인, 외과적 정출 후 수복하는 방법과, 인위적으로 발치하여 근관치료와 수복 후 재식하는 방법 등이 있다. 이중 외과적 정출술은 치아를 발거하여 파절부를 치은 연상으로 이동시켜 재식하는 방법으로서, 이는 치관부 파절편이 임상치근의 1/2 미만인 경우에 적응증이 될 수 있으며, 발견하지 못한 다른 파절편을 직접 시진할 수 있고 때로는 파절선을 순측에 위치시켜 치료시 시야확보 및 접근이 용이하다는 등의 장점이 있다. 본 증례에서는 외상으로 치관-치근 파절된 미완성 치근단의 상악 중절치를 가진 환아에서 외과적 정출술 후 근관치료와 광중합복합레진을 이용한 치관수복을 시행하였으며, 정기적 검진시 양호한 결과가 관찰됨을 확인할 수 있었다.

Crown-root fractures occur throughout both crown and root, and are defined as fractures involving enamel, dentin and cementum. The fractures may be grouped according to pulpal involvement into complicated and uncomplicated one. Crown-root fractures often occur on maxillary anterior teeth and comprise 5% of injuries affecting the permanent dentition and 2% in the primary dentition. To restore crown-root fractured tooth, biologic width must be maintained. For maintaining biologic width, such methods as gingivectomy following osteoplasty or orthodontic extrusion or surgical extrusion are available. Surgical extrusion is a method that extracts the tooth and replants the fractured tooth supragingivally. It is indicated when the length of the crown fragment is less than half the length of the clinical root. In these cases, root canal treatment and crown restoration using light-cured composite resin were performed after surgical extrusion. In following periodic examinations, favorable outcome was observed.

키워드

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