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Multidisciplinary approach for a patient with teeth loss and pathologic teeth migration: case report

치아 상실 및 치아의 병적 이동이 일어난 환자의 다과간 협력진료 증례

  • Gang, Sung-Nam (Department of Orthodontics, School of Dentistry, Chosun University) ;
  • Kim, Hyung-Moon (Department of Orthodontics, School of Dentistry, Chosun University) ;
  • Lee, Ji-Young (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Son, Mee-Kyoung (Department of Prosthodontics, School of Dentistry, Chosun University)
  • 강성남 (조선대학교 치의학전문대학원 교정학교실) ;
  • 김형문 (조선대학교 치의학전문대학원 교정학교실) ;
  • 이지영 (조선대학교 치의학전문대학원 보철학교실) ;
  • 손미경 (조선대학교 치의학전문대학원 보철학교실)
  • Received : 2014.10.02
  • Accepted : 2014.11.10
  • Published : 2014.12.31

Abstract

Patients who lost molars from dental caries or periodontitis have difficulty in maintaining their vertical dimension because their incisors and premolars also show vertical tooth movement. Missing posterior molars leads to occlusal interference and collapse of occlusal plane due to extrusion of opposite teeth and tipping of adjacent teeth. When this condition persists over long time, mandible moves forward, so it causes mobility and labioversion of upper incisors. This progress cannot be stopped spontaneously and the situation gets worse and worse. Therefore, for a patient with pathologic teeth migration caused by chronic periodontitis, interdisciplinary approach which is including periodontal treatment, orthodontic teeth alignment and prosthetic restoration of missing molars is required. This case report shows successful multidisciplinary approach to a patient who lost vertical dimension due to severe dental caries and periodontitis.

치주질환이나 우식으로 인해 구치부 치아가 상실된 환자들은 잔존하고 있는 전치부 및 소구치부 치아로 안정된 교합고경을 유지하기 어렵다. 구치의 상실로 대합치의 정출이나 인접치의 경사가 발생되는 경우 교합평면이 붕괴되거나 부적절한 교합간섭을 야기하게 된다. 만약 치아 상실 상태가 지속된 경우에는 하악의 전방이동으로 인해 상악 전치의 동요와 순측 이개를 초래하게 되며 치주질환이 동반된 경우에는 더욱 심각한 상황으로 변화한다. 이와 같이 치아의 병적 이동이 일어난 환자의 치료는 보존 및 치주치료, 교정 치료를 통한 재배열, 그리고 상실된 치아의 보철수복을 통한 교합 고경의 재설정 및 유지와 같은 다과간 협력 진료가 매우 중요하다.

Keywords

References

  1. Ong MA, Wang HL, Smith FN. Interrelationship between periodontics and adult orthodontics. J Clin Periodontol 1998;25:271-7. https://doi.org/10.1111/j.1600-051X.1998.tb02440.x
  2. Selwyn SL. An assessment of patients with periodontally involved migrated incisors. J Dent 1973;1:153-7. https://doi.org/10.1016/0300-5712(73)90027-4
  3. Southard TE, Behrents RG, Tolley EA. The anterior component of occlusal force. Part 1. Measurement and distribution. Am J Orthod Dentofacial Orthop 1989;96:493-500. https://doi.org/10.1016/0889-5406(89)90116-9
  4. Southard TE, Behrents RG, Tolley EA. The anterior component of occlusal force. Part 2. Relationship with dental malalignment. Am J Orthod Dentofacial Orthop 1990;97:41-4. https://doi.org/10.1016/S0889-5406(05)81707-X
  5. Towfighi PP, Brunsvold MA, Storey AT, Arnold RM, Willman DE, McMahan CA. Pathologic migration of anterior teeth in patients with moderate to severe periodontitis. J Periodontol 1997;68:967-72. https://doi.org/10.1902/jop.1997.68.10.967
  6. Brunsvold MA. Pathologic tooth migration. J Periodontol 2005;76:859-66. https://doi.org/10.1902/jop.2005.76.6.859
  7. Pinho T, Neves M, Alves C. Multidisciplinary management including periodontics, orthodontics, implants, and prosthetics for an adult. Am J Orthod Dentofacial Orthop 2012;142:235-45. https://doi.org/10.1016/j.ajodo.2010.10.026
  8. Martinez-Canut P, Carrasquer A, Magan R, Lorca A. A study on factors associated with pathologic tooth migration. J Clin Periodontol 1997;24:492-7. https://doi.org/10.1111/j.1600-051X.1997.tb00217.x
  9. Proffit WR. Equilibrium theory revisited: factors influencing position of the teeth. Angle Orthod 1978;48:175-86.
  10. Ericsson I, Lindhe J. Lack of significance of increased tooth mobility in experimental periodontitis. J Periodontol 1984;55:447-52. https://doi.org/10.1902/jop.1984.55.8.447
  11. Folio J, Rams TE, Keyes PH. Orthodontic therapy in patients with juvenile periodontitis: clinical and microbiological effects. Am J Orthod 1985;87:421-31. https://doi.org/10.1016/0002-9416(85)90202-7
  12. Polson AM, Reed BE. Long-term effect of orthodontic treatment on crestal alveolar bone levels. J Periodontol 1984;55:28-34. https://doi.org/10.1902/jop.1984.55.1.28
  13. Polson A, Caton J, Polson AP, Nyman S, Novak J, Reed B. Periodontal response after tooth movement into intrabony defects. J Periodontol 1984;55:197-202. https://doi.org/10.1902/jop.1984.55.4.197
  14. Gaumet PE, Brunsvold MI, McMahan CA. Spontaneous repositioning of pathologically migrated teeth. J Periodontol 1999;70:1177-84. https://doi.org/10.1902/jop.1999.70.10.1177
  15. Jin LJ, Cao CF. Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis. J Clin Periodontol 1992;19:92-7. https://doi.org/10.1111/j.1600-051X.1992.tb00446.x
  16. Palomo L, Palomo JM, Bissada NF. Salient periodontal issues for the modern biologic orthodontist. Semin Orthod 2008;14:229-45. https://doi.org/10.1053/j.sodo.2008.07.002
  17. Pinho T, Silva JA, Alfaiate D. Orthodontic management of a case with missing upper posterior teeth, severe curve of Spee and periodontal problems. Int J Stomatol Occl Med 2012;5:188-97. https://doi.org/10.1007/s12548-012-0063-6
  18. Riedel RA. A review of the retention problem. Angle Orthod 1960;30:179-99.
  19. Listgarten MA, Levin S. Positive correlation between the proportions of subgingival spirochetes and motile bacteria and susceptibility of human subjects to periodontal deterioration. J Clin Periodontol 1981;8:122-38. https://doi.org/10.1111/j.1600-051X.1981.tb02352.x
  20. Zachrisson BU. Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment. Am J Orthod 1976;69:285-300. https://doi.org/10.1016/0002-9416(76)90077-4