대한소아치과학회지 (Journal of the korean academy of Pediatric Dentistry)

  • 제36권3호
  • /
  • Pages.481-488
  • /
  • 2009
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  • 1226-8496(pISSN)
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  • 2288-3819(eISSN)
대한소아치과학회 (Korean Academy of Pediatric Dentistry)
권호 표지

Formocresol pulpotomy와 연관된 함치성 낭종의 치험례

DENTIGEROUS CYST ASSOCIATED WITH FORMOCRESOL PULPOTOMY

  • 주태준 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 박호원 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 이주현 (강릉.원주 대학교 치과대학 소아치과학교실) ;
  • 서현우 (강릉.원주 대학교 치과대학 소아치과학교실)
  • Ju, Tae-Joon (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Park, Ho-Won (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Lee, Ju-Hyun (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university) ;
  • Seo, Hyun-Woo (Department of pediatric dentistry, College of dentistry, Kangnung-Wonju national university)
  • 발행 : 2009.08.31
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초록

1904년 Buckley에 의해 치근관 살균제로 도입된 이후로 1:5로 희석된 formocresol을 사용한 치수절단술이 치아우식에 의한 유치의 비가역적 치수염시에 가장 많이 사용되어 왔다. Formocresol은 치수조직의 높은 고정능력으로 높은 임상적 성공률을 보이고 있으나 자체독성이 매우 강하여 영구 계승치 치배의 변위나 결손, 법랑질 형성 부전, 전신흡수로 인한 돌연변이 가능성과 암유발 가능성 역시 보고되고 있다. 또한 formocresol을 사용한 치수절단술 후에 과사용된 formocresol에 의한 만성적인 염증이 계승 영구치로 확산되어 퇴축법랑상피의 증식을 자극하고 법랑질로부터 퇴축법랑상피를 분리시켜 함치성 낭종을 형성할 수 있음이 보고되고 있다. 본 증례는 3년 전 응급으로 하악 좌측 제 2유구치의 formocresol을 사용한 치수절단술 후 정기 검진을 위해 내원한 환자의 방사선 사진에서 함치성 낭종이 발견되어 낭종 제거와 함께 유치의 발치를 시행했고 발치된 유치에서 formocresol cotton pellet이 제거되지 않은 채로 발견되어 formocresol이 장기간 남아있음으로 인해 낭종을 형성할 수 있음을 보고하는 바이다.

Buckley's formocresol was first introduced as a pulp medicament in 1904, and since 1930, it has been the treatment of choice for primary molar pulpotomies. Formocresol has fixation effect of pulp tissue and high clinical success rate. But side effect such as displacement and loss of permanent successor, amelogenesis imperfecta, cyst formation, mutation by general absorption, possibility of cancer induction have been reported. Of those, dentigerous cyst can form in the periradicular region after formocresol pulpotomy caused by an alteration of the reduced enamel epithelium, which result in fluid accumulation between the epithelium and the tooth crown. The present case describes a 6-year-old girl who had accidentally discovered in the panoramic radiograph a single, well-defined, radioluscent area enclosing the second unerupted mandibular premolar. The second left primary molar had been pulpotomizied 3 year before. Surgical treatment was carried out, the primary molar was extracted and cystectomy was performed under local anesthesia. In the extracted second primary molar, formocresol cotton pellet was left in the pulp chamber. Histologic study confirmed the suspected diagnosis of dentigerous cyst. This report present a case of dentigerous cyst associated with inadequate formocresol pulpotomized deciduous molar.

키워드

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