치관-치근 파절된 치아의 의도적 재식술 치험례

INTENTIONAL REPLANTATION OF THE CROWN-ROOT FRACTURED TOOTH: A CASE REPORT

  • 김수경 (경희대학교 치과대학 소아치과학교실) ;
  • 안승태 (경희대학교 치과대학 소아치과학교실) ;
  • 최성철 (경희대학교 치과대학 소아치과학교실) ;
  • 김광철 (경희대학교 치과대학 소아치과학교실) ;
  • 박재홍 (경희대학교 치과대학 소아치과학교실)
  • Kim, Soo-Kyoung (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Ahn, Seung-Tae (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Choi, Sung-Chul (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Kim, Kwang-Chul (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University) ;
  • Park, Jae-Hong (Department of Pediatric Dentistry, School of Dentistry, Kyung-Hee University)
  • 투고 : 2010.07.15
  • 심사 : 2010.08.13
  • 발행 : 2010.08.31

초록

수직적으로 치관-치근 파절된 전치부에서 파절은 치근을 따라 다양한 부위에서 일어나기 때문에 그 깊이에 따라 치료 방법이 결정된다. 파절선이 치관부에 근접한 경우 치은 판막을 형성하여 파절 부위를 노출시키거나 교정적 또는 외과적으로 치아를 정출시키는 방법 등을 고려해 볼 수 있지만, 파절선의 위치가 깊은 경우 그 예후는 불량하며 치근의 1/3 이상을 넘어선 경우에는 발치가 일반적이다. 그러나 성장기 아동에서 상악 중절치의 발치는 심미적 문제, 치조골 흡수, 발음 문제 등 여러 합병증을 초래하게 되므로 성장기 동안 치아를 보존하는 것을 최우선의 목표로 한다. 그러므로 수직 치관-치근 파절된 전치부 치아의 치료 시 발치 대신 복합레진으로 파절선을 수복한 후 재식하는 의도적 재식술을 대안으로 선택할 수 있다. 본 증례에서는 외상으로 인하여 상악 중절치의 치관-치근 파절이 치근 1/2 정도로 깊게 발생한 혼합치열기 환아에서 해당치아를 의도적으로 발치하고 복합레진으로 파절 부위를 수복한 후 재식하였다. 이후 2년 동안 관찰한 결과 특이한 임상적 증상 없이 유지되고 있으며 심미적으로도 만족할 만한 결과를 얻을 수 있었다. 이 방법은 술식에 민감하며 장기적 예후에 대한 보고는 부족하지만, 치아를 보존할 수 있는 새로운 방법이라는 점에서 가치가 있다고 사료된다.

As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.

키워드

참고문헌

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