SURGICAL EXTRACTION OF MULTIPLE SUPERNUMERARY TEETH BY TWO-STAGE PROCEDURE

상악 절치부에 매복된 다수 과잉치의 외과적 발거

  • Hong, Eun-Hye (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University) ;
  • Son, Heung-Kyu (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center Yonsei University)
  • 홍은혜 (연세대학교 치과대학 소아치과학교실) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실) ;
  • 손흥규 (연세대학교 치과대학 소아치과학교실) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실)
  • Published : 2008.05.30

Abstract

Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

과잉치란 정상에 비해 많은 수의 치아를 일컫는 것으로 유치열기와 혼합치열기에 발생하며, 여러 가지 임상적 문제를 일으킬 수 있다. 특히 상악 전치부의 과잉치는 상악 전치의 맹출 장애 및 전위, 정중부의 치간 이개, 치근 흡수, 함치성낭종 형성 등의 문제를 유발할 수 있으므로 조기에 진단하고, 과잉치의 위치 및 수, 형태에 따라 적절한 치료를 시행하는 것이 중요하다. 이 증례는 상악 전치부에 네 개의 과잉치가 영구치의 맹출을 방해하고 있는 경우로, 발거 시 합병증을 최소화하기 위하여 두 단계로 나누어 발거하였다. 컴퓨터 단층 촬영에서 네 개의 과잉치가 주위의 영구치 맹출을 방해하고 있었고, 그 중 두 개의 과잉치는 절치 치배에 매우 근접해 있었다. 네 개의 과잉치를 동시에 제거할 경우 영구 치배에 손상을 줄 위험이 있으므로 두 개의 역위 매복된 원추형의 과잉치만 먼저 발거하였다. 남은 두 개의 과잉치는 위치가 변화되기를 기다린 후 두 번째 발거 수술을 시행하여, 주위 절치 치배에 손상을 가하지 않고 치조골 삭제를 적게 하여 합병증 발생을 줄일 수 있었다.

Keywords

References

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