Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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ORTHODONTIC TRACTION OF IMPACTED POSTERIOR TEETH : CASE REPORTS

매복 구치부 치아의 교정적 이동 : 증례 보고

  • Maeng, Yu-Jin (Hallym Sacred Heart Hospital, pediatric dentistry) ;
  • Oh, So-Hee (Hallym Sacred Heart Hospital, pediatric dentistry)
  • 맹유진 (한림대학교 성심병원 소아치과) ;
  • 오소희 (한림대학교 성심병원 소아치과)
  • Published : 2009.11.30
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Abstract

Impacted molars are not usual with the prevalence rate of less than 1%, however problems such as infraocclusion, extrusion of the opposite tooth and lack of space are caused. If molars are impacted, radiographic check-up and observations are needed as they play an important role in skeletal development and mastication. Causes of impaction are underdevelopment of roots, supernumerary teeth, cysts, odontomas, ankylosis and etc. In our first case, we present impacted molar which was surgically exposed and orthodontically traded. As the developmental state of the root was less than half at first visit, we observed until the root was 2/3 in its length and traction was carried out. The second case is orthodontic traded molar with compleate enucleation of the existing cysts. When trading impacted molars, direct bonding of attachments to the tooth and light continuous forces are recommended so as to ankylosis, external absorption and periodontal attachment loss avoid. Fixed appliances tract the teeth on arch and obtain eruption spaces without patient's cooperation. We report surgically exposed and orthodontically traded molars which resulted in good occlusion and patients satisfaction.

구치부 매복은 1% 이내로 드문 편이지만 저위 교합, 반대 악궁 치아의 정출, 인접치 경사로 인한 공간 부족 등의 문제가 발생하게 된다. 구치부 치아는 교합 및 악골 발육에 관여하는 기능적으로 중요한 치아이므로 초기 혼합 치열기부터 지속적인 방사선 사진을 찍어 매복 여부를 관찰해야 한다. 매복의 원인에는 치근 발육의 저하, 과잉치, 낭종, 치아종, 유착 등이 있다. 첫 번째 증례에서는 초진 시 치근 발육이 1/2이하라서 자발적 맹출을 기대하였지만 2/3이상 발육 시에도 맹출 하지 못하여 외과적 노출 및 교정적 견인을 시함하였다. 두 번째 증례는 낭종을 포함하는 매복 구치를 주소로 내원하였고 낭종 크기가 작고 인접 부위에 주요한 해부학적 구조물이 없어 완전한 적출술을 시행 후 교정적 견인을 하였다. 교정적 견인 시 해당 치아에 직접 어태치먼트(attachment)를 붙인 후 악하고 지속적인 힘을 적용하는 것이 유착, 외흡수, 치주 부착 소실 등의 부작용이 나타나지 않는다. 또한 고정식 장치를 사용하면 환자의 협조도가 필요 없고 맹출 공간을 확보하면서 호선상에 매복치를 견인 할 수 있다. 본 증례에서는 매복 구치를 외과적 노출 및 교정적 견인을 통해 교합상으로 배열을 하여 양호한 결과를 얻었기에 보고하는 바이다.

Keywords

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