Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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ROOT RESORPTION OF PRIMARY TEETH WITHOUT PERMANENT SUCCESSORS

계승영구치가 선천적 결손된 유치의 치근 흡수

  • Lee, Jung-Eun (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Song, Je-Seon (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Son, Heung-Kyu (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University)
  • 이정은 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 손흥규 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실, 구강과학연구소)
  • Published : 2009.11.30
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Abstract

Root resorption of primary teeth usually occurs as the succeeding permanent teeth erupt, which induces differentiation of the hemopoietic cells into osteoclasts. Their root resorption pattern reflects the eruption path of the succeeding permanent teeth, and eventually the primary teeth shed as their succeeding permanent teeth erupt. Even when a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc. Such congenital missing of permanent teeth is a commonly observed phenomenon in human be ing, and it often accompanies delayed retention of primary teeth. The etiologic factors for congenital missing in elude not only systemic diseases, but also local factors and human evolution process. In the radiographs of the cases in this report, the primary teeth without succeeding permanent teeth show pathologic root resorption. Root resorption progressed about 1/2~3/4 of the roots, and the surfaces of the resorption area were irregular. Considering high susceptibility of the periodontal ligament of primary teeth to root resorption, pathologic root resorption of primary teeth with delayed retention can be explained by the increased masticatory muscle force and abnormal occlusion developed during the mixed dentition. When the primary teeth without succeeding permanent teeth are lost, decision for space maintenance is required and long-term treatment plan for further prosthetic or orthodontic treatment should be establsihed.

유치의 정상적인 치근 흡수는 계승 영구치의 맹출 압력으로 단핵구 세포가 방출되어 파골세포로의 분화가 촉진되어 일어나며, 계승 영구치의 맹출 경로를 따라 유치의 치근이 흡수되어서 유치가 탈락하게 된다. 계승 영구치가 선천적으로 결손되었을 때에도 유치의 치근은 흡수될 수 있는데, 유치의 비정상적 치근흡수는 외상이나 염증, 교합압의 증가, 지지조직의 약화 등으로 발생할 수 있다. 치아의 선천적 결손은 인간에서 가장 흔한 발육이상이며, 영구치가 결손되었을 때 유치는 만기 잔존할 수 있다. 영구치의 선천적 결손은 전신질환이 있는 경우뿐만 아니라 국소적 원인이나 인류 진화에 따른 영향 등에 의해서도 발생한다. 이 증례들은 계승 영구치가 선천적으로 결손된 어린이에서 유치의 치근이 비정상적으로 흡수된 경우로 계승 영구치가 결손 된 유전치와 유견치, 유구치의 치근이 1/2 ~ 3/4정도까지 흡수 되었으며 흡수 부위는 불규칙적인 형태를 보였다. 원인으로는 흡수에 감수성이 높은 유치의 치주인대, 그리고 성장에 따라 증가되는 저작근육과 저작력, 혼합치열기에 유발되는 비정상적 교합 등을 생각할 수 있다. 계승 영구치가 결손된 유치가 비정상적인 치근 흡수를 보이는 경우에 유치는 유지될 수도 있지만, 여러 요인에 의하여 탈락될 경우에는 공간을 유지 할 것인지 판단해야 하며, 향후 보철치료나 교정치료를 요하므로 장기적인 치료계획을 수립해야 한다.

Keywords

References

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