ERUPTION GUIDANCE OF IMPACTED MANDIBULAR FIRST MOLAR

매복된 하악 제1대구치의 맹출 유도

  • Lee, Doo-Young (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) ;
  • Lee, Jae-Ho (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) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University)
  • 이두영 (연세대학교 치과대학 소아치과학교실) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소)
  • Received : 2010.01.05
  • Accepted : 2010.03.22
  • Published : 2010.05.31

Abstract

Incidence of tooth impaction varies from 5.6 to 18.8% of the population. Failure of eruption of the first and second permanent molars is rare; the prevalence in the normal population is 0.01% in case of the first permanent molar, and 0.06% in case of the second permanent molar. Permanent molars are particularly important for providing sufficient occlusal support and co-ordinating facial growth. Failure of eruption of permanent molars may result in various complications such as decrease in vertical dimension, posterior open bite, extrusion of antagonistic teeth, resorption and inclination of adjacent teeth, formation of cyst and so on. Treatment options of impacted teeth are periodic observation, surgical exposure, surgical exposure with subluxation, orthodontic relocation, and surgical extraction before prosthetic treatment. Early diagnosis and treatment are important, because delayed treatment induces various problems such as decreased spontaneous eruptive force, decreased successful percentage, increased treatment period, increased various complications. Prevalence of the failure of mandibular first molars is rare but eruptive guidance before extraction of impacted teeth is necessary due to importance of permanent molars. We reported two cases of surgical exposure of impacted mandibular first molar. In these cases, we could observe different result of the impacted mandibular first molar after surgical exposure.

영구치의 매복은 다양한 빈도로 보고되며, 인구 집단의 약 5.6~18.8%에서 발생한다. 그 중에서 하악 제2대구치의 맹출장애 빈도는 약 0.06%, 하악 제1대구치는 약 0.01%로 매우 드물게 나타난다. 영구 대구치는 기능적으로 저작을 위한 중요한 교합적 지지를 제공하며 안면의 조화로운 성장발육에 중요한 역할을 담당한다. 영구 대구치의 매복시 발생되는 문제점으로는 구치부의 개방교합과 대합치의 정출, 인접치의 치근흡수와 기울어짐, 낭종의 형성, 심할 경우 하안면고경의 감소 등 여러 가지 문제점이 유발될 수 있다. 매복치의 치료 방법으로는 우선적으로 외과적노출술을 생각해 볼 수 있으며, 외과적노출술 후에 추가적인 인위적 아탈구로 자발적맹출을 기대해 볼 수도 있다. 자발적맹출이 관찰되지 않으면 교정적 강제 견인이나 외과적재위치술을 고려해 볼 수 있으며, 최악의 경우에는 발치 후 보철치료를 준비해야 할 것이다. 맹출장애를 보이는 치아의 조기진단과 치료는 중요한 의미를 갖는데, 늦은 시기에 발견될 경우 자발적 맹출력이 감소되어 치료의 성공률도 감소하고, 치료기간도 증가하며 임상적으로 다양한 합병증을 야기하기 때문이다. 따라서, 하악 제1대구치의 맹출장애를 조기에 발견할 경우 우선적으로 맹출유도를 고려해 볼 필요가 있다. 다음 두 증례는 매복된 하악 제1대구치에 대하여 외과적 노출술을 시행 후 자발적 맹출을 기대하였으나 상반된 결과를 얻었기에 보고하는 바이다.

Keywords

References

  1. 대한소아치과학회: 소아.청소년치과학. 신흥인터내셔날, 서울, 54-60, 2007.
  2. Raghoebar GM, Boering G, Vissink A, Stegenga B : Eruption disturbances of permanent molars: a review. J Oral Pathol Med, 20:159-166, 1991. https://doi.org/10.1111/j.1600-0714.1991.tb00913.x
  3. Palma C, Coelho A, Gonzalez Y, Cahuana A.: Failure of eruption of first and second permanent molars. J Clin Pediatr Dent, 27:239-246, 2003.
  4. 김은정, 김난진, 조호진 등 : 외과적 노출술을 이용한 매복된 하악 제1대구치의 자발적 맹출 유도. 대한소아치과학회지, 31:598-604, 2004.
  5. Ohman I, Ohman A : The eruption tendency and changes of direction of impacted teeth following surgical exposure. Oral Surg, 49:383-389, 1980. https://doi.org/10.1016/0030-4220(80)90279-0
  6. Proffit WR, Vig KW : Primary failure of eruption: a possible cause of posterior open-bite. American Journal of Orthodontics, 80:173-190, 1981. https://doi.org/10.1016/0002-9416(81)90217-7
  7. Otsuka Y, Mitomi T, Tomizawa M, Noda T : A review of clinical features in 13 cases of impacted primary teeth. International Journal of Pediatric Dentistry, 11:57-63, 2001. https://doi.org/10.1046/j.1365-263x.2001.00236.x
  8. Kokich VG, Mathews DP: Surgical and orthodontic management of impacted teeth. Dental clinics of North America, 37:181-204, 1993.
  9. Tiwana PS, Kushner GM : Management of Impacted teeth in children. Oral Maxillofacial Surg Clin N Am, 17:365-373, 2005. https://doi.org/10.1016/j.coms.2005.09.001
  10. Baccetti T: Tooth anomalies associated with failure of eruption of first and second permanent molars. Am J Orthod Dentofacial Orthop, 118:608-610, 2000. https://doi.org/10.1067/mod.2000.97938
  11. Nakano K, Matsuoka T, Takahashi A, et al. : Delayed development or congenital absence of a single first permanent molar in Japanese child patients. International Journal of Paediatric Dentistry, 9:271-276, 1999. https://doi.org/10.1111/j.1365-263X.1999.00145.x
  12. Fujiyama K, Yamashiro T, Fukunaga T, et al. : Denervation resulting in dento-alveolar ankylosis associated with decreased Malassez epithelium. Journal of Dental Research, 83:625-629, 2004. https://doi.org/10.1177/154405910408300808
  13. Bang E, Kjaer I, Christensen LR : Etiological aspects and orthodontic treatment of unilateral localized arrested tooth development combined with hearing loss. American Journal of Orthodontic and Dentofacial Orthopedics, 108:154-161, 1995. https://doi.org/10.1016/S0889-5406(95)70078-1
  14. Becktor KB, Bangstrup MI, Rolling S, Kjaer I : Unilateral primary or secondary retention of permanent teeth and dental malformations. European Journal of Orthodontics, 24:205-214, 2002. https://doi.org/10.1093/ejo/24.2.205
  15. Andreasen JO, Petersen JK, Laskin DM : Textbook and Color Atlas of Tooth Impactions. Copenhagen, Denmark:Munksgaard, 199-208, 1997.
  16. Magnusson C, Kjellberg H: Impaction and Retention of Second Molars: Diagnosis, Treatment and Outcome. Angle Orthodontist, 79:422-427, 2009.
  17. Frank CA: Treatment options for impacted teeth. JADA, 131:623-632, 2000.
  18. Moss JP : An orthodontic approach to surgical problems. Am J Orthod, 68:363-390, 1975. https://doi.org/10.1016/0002-9416(75)90179-7
  19. Lownie JF, Cleaton-Jones PE, Fatti P, Lownie MA : Autotransplantation of maxillary canine teeth: a follow- up of 35 cases up to 4years. Int J Oral Maxillofac Surg, 15:282-287, 1986. https://doi.org/10.1016/S0300-9785(86)80086-2
  20. Alling CC, Catone GA : Management of impacted teeth. J Oral Maxillofac Surg, 51:3-6, 1993. https://doi.org/10.1016/0278-2391(93)90004-W
  21. 유정민, 김종수, 김용기: 매복 미맹출 제1대구치의 외과적 노출과 교정력을 이용한 견인의 치험례. 대한소아치과학회지, 23:859-865, 1996.
  22. Shapira Y, Borell G, Kuftinec M, Nahlieli O : Bringing impacted mandibular second premolars into occlusion. JADA, 127:1075-1078, 1996.
  23. Nielsen SH, Becktor KB, Kjaer I.: Primary retention of first permanent mandibular molars in 29 subjects. European Journal of Orthodontics, 28:529-534, 2006. https://doi.org/10.1093/ejo/cjl049
  24. Frank CA : Treatment options for impacted teeth. J Am Dent Assoc, 131:623-632, 2000.
  25. Geiger AM, Bronsky MJ : Orthodontic management of ankylosed permanent posterior teeth: A clinical report of three cases. Am J Orthod Dentofac Orthop, 106:543-548, 1994. https://doi.org/10.1016/S0889-5406(94)70078-8
  26. Valmaseda-Castellon E, De-la-Rosa-Gay C, Gay-Escoda C : Eruption disturbances of the first and second permanent molars:Results of treatment in 43 cases. Am J Orthod Dentofac Orthop, 116:651-658, 1999. https://doi.org/10.1016/S0889-5406(99)70200-3
  27. 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
  28. Proffit WR : Contemporary orthodontics. St. Louis, Mosby, 217-219, 403-410, 1993.
  29. Bodenham RS : The treatment and prognosis of unerupted maxillary incisors associated with the presence of supernumerary teeth. Br Dent J, 123:173-177, 1967.
  30. Kaban LB, Needleman HL, Hertzberg J : Idiopathic failure of eruption of permanent molar teeth. Oral Surg, 42:155-163, 1976. https://doi.org/10.1016/0030-4220(76)90118-3