Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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ROOT MALFORMATION OF PERMANENT INCISORS BY ALVEOLAR BONE FRACTURE

치조골 골절을 동반한 유치열기 외상에 의한 영구절치의 치근 형성 이상

  • Ji, Eun-Hye (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Son, Heung-Kyu (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Kim, Seung-Hye (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University) ;
  • Song, Je-Seon (Department of Pediatric Dentistry, College of Dentistry and Oral Science Research Center, Yonsei University)
  • 지은혜 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 손흥규 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 김승혜 (연세대학교 치과대학 소아치과학교실, 구강과학연구소) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실, 구강과학연구소)
  • Received : 2011.05.04
  • Accepted : 2011.08.20
  • Published : 2011.08.31
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Abstract

During tooth formation, tooth development can be affected by physical action or metabolic changes around dental follicle. Especially trauma to primary dentition is the most representative physical factor that can cause development disorders of succedaneous tooth. Enamel hypoplasia and crown discoloration of succedaneous tooth are common complications of trauma. And impaction, ectopic eruption, arrest of root formation and root dilaceration of succedaneous tooth are rare. In this case, a 6-year and 5-month-old female patient visited for dental evaluation after trauma. She was diagnosed with alveolar bone fracture near upper front teeth, extrusion of the upper right and left primary central incisors, intrusion of the upper right primary lateral incisor, and palatal luxation of the upper left primary lateral incisor. Upper right and left primary central incisors with severe mobility were extracted, with gingival suture on the day of the visit. During 24 months check up, root dilacerations were found near the cemento enamel junction in the upper lateral incisors and arrests of root formation were found on the coronal 1/3 of the root in the upper central incisors. Although alveolar bone fracture is rare type of trauma in children, a thorough examination of alveolar bone is essential for prognosis and following treatment in patients with trauma.

치아형성 과정 중 치배 주위의 물리적 작용이나 대사 환경의 변화로 치아 발생은 영향을 받을 수 있다. 유치열기에 가해진 외상은 계승 영구치의 발생에 장애를 초래시킬 수 있는 가장 대표적인 물리적 요인으로 이로 인한 합병증으로 계승 영구치의 법랑질 변색 및 저형성증이 가장 흔히 발생하고 드물게 매복, 이소 맹출, 치근 형성 정지 및 치근 만곡 등이 나타난다. 본 증례에서는 만 6세 5개월의 여자 어린이 환자가 안면부 외상을 주소로 내원하여 상악 좌우 유중절치의 정출성 탈구, 상악 우측 유측절치의 함입성 탈구, 상악 좌측 유측절치의 구개측 측방 탈구로 진단되었고, 상악 치은부의 열상과 상악 전치부의 치조골 골절이 관찰되었다. 내원 당일 치과 응급실에서 동요도가 심한 상악 좌우 유중절치의 발치 후 치은 봉합술을 시행하였다. 24개월 정기 검진 중 방사선 사진 상에서 상악 좌,우측 측절치의 백악 법랑 경계(Cemento enamel junction, CEJ) 근방에 치근 만곡이 관찰되었고 상악 중절치 치근의 치관부 1/3부위에서 치근 형성이 정지되고 있는 양상이 관찰되었다. 치조골 골절이 어린이에서 흔하게 나타나는 외상의 유형은 아니나 본 증례에서와 같이 치근 발육이상 등 여러 합병증을 일으킬 수 있으므로 외상을 입은 환아에서 치조골 골절 여부에 대한 면밀한 검사 및 주기적인 검진은 예후 예측 및 향후 치료에 있어서 중요할 것이다.

Keywords

References

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