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미성숙 영구치의 탈구성 외상 이후 계속된 치근 성장

CONTINUED ROOT DEVELOPMENT AFTER AVULSION OF IMMATURE TEETH

  • 이주은 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김영진 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김현정 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 남순현 (경북대학교 치의학전문대학원 소아치과학교실)
  • Lee, Ju-Eun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Young-Jin (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Jung (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Nam, Soon-Hyeun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
  • 투고 : 2013.01.10
  • 심사 : 2013.05.14
  • 발행 : 2013.05.31

초록

외상에 의한 미성숙 영구치의 손상은 유치열에서 영구치열로 이환되는 8~10세경에 가장 빈발하며 전체 외상 환자의 높은 빈도를 차지한다. 외상에 대한 결과는 치아의 파절, 전위, 함입, 정출, 탈구 등의 경조직 손상 뿐 아니라 치수, 치주인대, Hertwig 상피 근초, 치조골, 치은 및 구강점막 등의 치아 인접조직의 손상도 포함한다. 일반적으로 Hertwig 상피 근초는 외상성 손상에 취약하지만, 때때로 감염이나 외상에 의한 손상을 견디고 생활력을 유지하여 치근성장에 대한 정상적인 기능을 수행하는 것이 보고된 바 있다. 본 증례에서는 외상에 의해 완전 탈구된 미성숙 영구치를 가진 두 명의 환자에 대해 보고하고자 한다. 첫 번째 환자의 경우 탈구된 상악 중절치를 재식하였고 두 번째 환자의 경우 탈구된 하악 중절치를 재식하지 않았다. 하지만 두 환자 모두에서 탈구된 치아의 치조와 부위에 분리된 치근의 계속적인 성장을 보이는 바 이를 보고하고자 하며, 나아가 계속적인 치근형성에 있어서 미성숙 치수 조직과 Hertwig 상피 근초의 생활력 보존이 결정적임을 알리고자 한다.

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

키워드

참고문헌

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