혼합치열기에 있는 법랑질형성부전증 환아의 이행적 치료

TRANSITIONAL TREATMENT OF AMLEOGENESIS IMPERFECTA IN MIXED DENTITION: A CASE REPORT

  • 황지영 (경희대학교 치과대학 소아치과학교실) ;
  • 최영철 (경희대학교 치과대학 소아치과학교실) ;
  • 김광철 (경희대학교 치과대학 소아치과학교실) ;
  • 박재홍 (경희대학교 치과대학 소아치과학교실) ;
  • 최성철 (경희대학교 치과대학 소아치과학교실)
  • Hwang, Ji-Young (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Choi, Yeong-Chul (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Kim, Kwang-Chul (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Park, Jae-Hong (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Choi, Sung-Chul (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University)
  • 발행 : 2009.11.30

초록

법랑질형성부전증은 치아 법랑질의 유전성 결함으로 임상적으로 형성부전형, 성숙부전형, 석회화부전형의 3가지로 나뉜다. 이 질환은 유치와 영구치에서 모두 발생할수 있다. 본 증례의 환자는 8세 8개월에 상악 영구 전치의 맹출지연 및 하악 전치부위 치석, 전치부 개방교합을 주소로 개인병원에서 의뢰되어 본과에 내원하였다. 본과에서 임상검사 결과, 상, 하악 전치부의 얇은 법랑질과 좁은 치아 폭경을 보였으며, 특히 하악 전치부는 전체적인 형태상 불량하고 거친 표면을 나타냈다. 또한 온도 자극에 민감한 반응을 나타냈다. 상, 하악 제 1 대 구치는 심한 법랑질 파절과 마모를 보였다. 방사선 검사에서 전반적인 법랑질형성부전증을 보였으며 맹출하지 않은 치아에서도 법랑질형성부전증을 볼 수 있었다. 이에 본 환아는 형성부전형 법랑질형성부전증으로 진단내렸으며, 경희대학교 소아치과와 보철과의 협진하에 치료를 시행하였으며 지속적인 관찰 중이다. 법랑질형성부전증 환자의 효율적인 저작능력, 심미성 회복, 지각과민증 해소를 위하여 구강 위생교육, 구치부 및 전치부의 수복이 필요하다. 성장이 완료될 때까지 지속적인 예방치료 및 치아 수복이 필요하며 성장 완료 후에는 여러 과의 협진적 치료가 필요하다.

Amelogenesis Imperfecta (AI) is a genetic disorder which retards the development of enamel and it can be classified into three types: hypoplastic, hypomaturation, hypocalcified type. This can occur both in deciduous and permanent dentition. A 8 year 8 month old patient with a chief complaints of delayed eruption on upper anteriors, calculus deposit on lower anteriors and anterior openbite visited the clinic. Anteriors had thin layer of enamel and were very narrow. Especially lower anteriors had rough surface and were in bad shape. Teeth were very hypersensitive to thermal changes. Upper and lower first molars showed severe attrition on the occlusal surface. Radiographs also verified hypoplastic enamel in the whole dentition including the teeth in the tooth bud. The patient was diagnosed as hypoplastic AI, and is being treated at the pediathc and prosthodontic department of the Kyunghee dental university hospital. To improve the function, esthetics, hypersensitivity of the AI patients, restorations on the posteriors and the anteriors with oral hygiene instruction are necessary, Constant follow-up check is needed until full growth and after full growth, cooperative care with the other department is needed.

키워드

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