ERUPTION DISTURBANCE OF THE LOWER LEFT FIRST PERMANENT MOLAR CAUSED BY AMELOBLASTIC FIBROMA

법랑모세포섬유종에 의한 하악 제1대구치의 맹출 장애

  • Kim, Seung-Hye (Department of Pediatric Dentistry, 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, Hyung-Jun (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)
  • 김승혜 (연세대학교 치과대학 소아치과학교실) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 손흥규 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소)
  • Published : 2010.02.26

Abstract

Impaction is the cessation of eruption process caused by physical obstacles on the eruption pathway, abnormal tooth position, or lack or space. It often occurs in association with supernumerary teeth, odontogenic tumor, or cystic lesions, and ameloblastic fibroma is one of the odontogenic tumors that can cause impaction of teeth. In many cases, ameloblastic fibroma occurs in association with one or more unerupted teeth. The proper management of ameloblastic fibroma is determined between conservative resection or more aggressive block resection, based size and morphologic features of the lesion and age of the patient. This is a case of a 8 year and 6 month old boy whose lower left permanent molar showed eruption disturbance. The impacted tooth was successfully repositioned favorably through surgical exposure and orthodontic traction using a modified halterman appliance. Long term follow-up, longer than 10 years, is planned considering relatively high recurrence rate and possibility of malignant transformation of ameloblastic fibroma, which cause impaction of the lower left permanent molar in this case.

매복이란 맹출로 상에 물리적 장애물이 있거나, 치아의 비정상적 위치, 또는 공간 부족 등으로 인해 맹출이 정지되는 경우이다. 이는 과잉치, 치성 종양, 또는 낭성 병소의 존재와 연관되어 나타나기도 하는데, 법랑모세포섬유종은 이러한 매복을 일으킬 수 있는 치성 종양의 한 종류이다. 법랑모세포섬유종은 많은 경우 미맹출 치아나 매복치와 연관되어 나타나며, 병소의 크기 및 양상, 그리고 환자의 연령을 고려하여 보존적 절제술(conservative resection) 또는 완전 절제술(block resection)을 시행한다. 본 증례는 하악 좌측 제1대구치의 맹출 장애를 주소로 내원한 환아에서 외과적 노출술 및 변형된 halterman 장치를 사용한 교정적 견인을 통하여 양호한 결과를 얻었기에 보고하는 바이다. 매복의 원인이었던 법랑모세포섬유종의 비교적 높은 재발률 및 악성 전환 가능성을 고려하여 추후 장기적인 추적검사가 필요할 것으로 사료된다.

Keywords

References

  1. Ten Cate AR : 구강조직학. 2판. 과학서적센터, 서울, 318-323, 1994.
  2. Peterson LJ : Principles of Management of the Impacted Teeth. In Peterson LJ, Ellis III E, Hupp JR, Tucker MR (ed) Contemporary Oral And Maxillofacial Surgery. 3rd ed, The C.V. Mosby Company, St Louis, 215-248, 1998.
  3. Baccetti T : Tooth anomalies associated with failure of eruption of first and second permanent molars. Am J Orthod Dentofac Orthop, 118:608-610, 2000. https://doi.org/10.1067/mod.2000.97938
  4. Grover PS, Lorton L : The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Pathol, 59:420-425, 1985. https://doi.org/10.1016/0030-4220(85)90070-2
  5. Regezi JA, Sciubba JJ : Oral pathology. Clinicalpathologic correlations. WB Saunders, Philadelphia, 469-471, 1989.
  6. Johnson JV, Quirk GP : Surgical repositioning of impacted mandibular second molar teeth. Am J Orthod Dentofac Orthop, 91:242-251, 1987. https://doi.org/10.1016/0889-5406(87)90454-9
  7. Raghoebar GM, Boering G, Vissink A, Stegenga B : Eruption disturbances of permanent molar: a review. J Oral Pathol Med, 20:159-166, 1991. https://doi.org/10.1111/j.1600-0714.1991.tb00913.x
  8. Proffit WR, Vig KW : Primary failure of eruption: a possible cause of posterior open-bite. Am J Orthod, 80:173-190, 1981. https://doi.org/10.1016/0002-9416(81)90217-7
  9. Oliver RG, Richmond S, Hunter B : Submerged permanent molars : four case reports. Br Dent J, 160:128-130, 1986. https://doi.org/10.1038/sj.bdj.4805789
  10. Raghoebar GM, Boering G, Jansen HWB, Vissink A : Secondary retention of permanent molar: a histologic study. J Oral Pathol Med, 18:427-431, 1989. https://doi.org/10.1111/j.1600-0714.1989.tb01338.x
  11. Suri L, Gagari E, Vastardis H : Delayed tooth eruption: Pathogenesis, diagnosis, and treatment. A literature review. Am J Orthod Dentofac Orthop, 126:432-445, 2004. https://doi.org/10.1016/j.ajodo.2003.10.031
  12. Dimitrakopoulos I, Psomaderis K, Zaraboukas T: Ameloblastic fibroma of the mandible associated with root resorption and unerupted teeth: A case report. Quintessance Int. 39:523-527, 2008.
  13. Slootgweg PJ: An analysis of the inter-relationship of the mixed odontogenic tumors-ameloblastic fibroma, amaloblastic fibro-odontoma, and the odontomas. Oral Surg, 51:266-76, 1981. https://doi.org/10.1016/0030-4220(81)90056-6
  14. Neville B, Damm D, Allen C, Bouquot J : Oral and maxillofacial pathology. 2nd ed, W.B. Saunders, Phildelphia, 626-628, 2002.
  15. Baroni Ch, Farneti M, Stea S, Rimondini L : Ameloblastic fibroma and impacted mandibular first molar. Oral Surg Oral Med Oral Pathol, 73:548-549, 1992. https://doi.org/10.1016/0030-4220(92)90095-8
  16. Tacar F, T¨umer C, Ayhan A, et al. : A mandibular radiolucency in a 9 year old. Oral Surg Oral Med Oral Pathol, 84:231-233, 1997. https://doi.org/10.1016/S1079-2104(97)90335-8
  17. Proffit WR : Equilibirum theory revisited: factors influencing position of the teeth. Angle Orthod, 48:175-186, 1978.
  18. Shafer WG, Hine MK, Levy BM : A textbook of oral pathology. 4th ed, WB Saunders, Philadelphia, 66- 69, 1983.
  19. Palma C, Coelho A, Gonzalez Y, Cahuana A : Failure of eruption of first and second permanent molars. J Clin Pediatr Dent, 27:239-245, 2003.
  20. 김은정, 김난진, 조호진 등 : 외과적 노출술을 이용한 매복된 하악 제1대구치의 자발적 맹출 유도. 대한소아치과학회지, 31:598-604, 2004.
  21. Sapp J, Eversole L, Wysocki G : Contemporary oral and maxillofacial pathology. 2nd ed, Elsevier, New York, 158-159, 2004.
  22. Kobayashi K, Murakami R, Fujii T, Hirano A : Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: Case report and review of the literature. J craniomaxillofac Surg, 33:352-355, 2005. https://doi.org/10.1016/j.jcms.2005.04.006
  23. Vallejo GP, Garcia M, Alvarez L, et al. : Ameloblastic fibroma: a case report in a 6 year old. J Clin Pediatr Dent, 25:245-248, 2001.
  24. Chen Y, Wang JM, Li TJ : Ameloblastic fibroma: A review of published studies with special reference to its nature and biological behavior. Oral Oncol, 43:960-969, 2007. https://doi.org/10.1016/j.oraloncology.2007.05.009
  25. Jacobs SC : The surgical exposure of teeth: simplest, safest and best? Austr Orthod J, 10:5-11, 1987.
  26. Vanarsdall RL, Corn H : Soft tissue management of labially positioned unerupted teeth. Am J Orthod, 72:53-64, 1977. https://doi.org/10.1016/0002-9416(77)90124-5
  27. 조윤정, 박영옥, 김태완 등 : 매복된 하악 제1대구치의 외과적 노출술을 이용한 치험례. 대한소아치과학회지, 34:322-327, 2007.
  28. Babacan H, Ay S, Kosger H : Impacted permanent first molars: two case reports. Int Dent J, 56:49-54, 2006.