Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Autotransplantation of Ectopically Impacted Teeth : Two Case Reports

이소매복된 치아의 자가치아이식 증례

  • Lim, Yuran (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Kim, Jaehwan (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Choi, Namki (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Kim, Seonmi (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University)
  • 임유란 (전남대학교 치과대학 소아치과학교실) ;
  • 김재환 (전남대학교 치과대학 소아치과학교실) ;
  • 최남기 (전남대학교 치과대학 소아치과학교실) ;
  • 김선미 (전남대학교 치과대학 소아치과학교실)
  • Received : 2016.06.21
  • Accepted : 2016.07.28
  • Published : 2017.02.28
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Abstract

Numerous therapeutic approaches are available for impacted teeth, including orthodontic retraction, implantation, and autogenous tooth transplantation. Autotransplantation is a promising method, especially for juvenile patients, as it enables preservation of the function of the periodontal tissues, as well as continued alveolar bone growth. This report describes autotransplantation in two cases in which the tooth was fully-ectopically impacted. With case 1, an ectopically impacted premolar was extracted and transplanted in an upright position, and regenerative endodontic treatment was performed using a platelet-rich fibrin clot and mineral trioxide aggregate (MTA). With case 2, a calcifying odontogenic cyst with an impacted left mandibular second molar was treated by enucleation. The tooth was transplanted into the proper position 3 months after enucleation, and endodontic treatment was performed using MTA. In both cases, autotransplantation appeared to provide a simple and rapid treatment option for patients with ectopically impacted teeth. These cases demonstrate that autotransplantation of ectopically impacted teeth is a viable treatment option rather than implant placement or prosthesis, especially in juvenile patients.

매복치의 치료방법으로 교정적 견인, 발치 후 임플란트, 자가치아이식 등 다양한 치료 방법이 있다. 그 중에서도 자가치아이식은 성장하는 환자들에게서 이식치 고유의 치주인대세포의 보존 및 치조골 성장이 가능하다는 점에서 좋은 치료방법이라고 생각된다. 이 증례에서는 성장중인 청소년의 이소 매복 치아를 자가치아이식으로 치료한 두 개의 증례를 소개하고자 한다. 첫 번째 증례에서 이소 매복된 좌측 하악 제2소구치를 발거 후 정위치로 자가치아이식하였고 혈소판 농축 피브린(PRF)과 mineral trioxide aggregate (MTA)를 사용하여 재생 근관 치료를 하였다. 석회화 치성낭으로 인해 이소매복된 좌측 하악 제2대구치를 지닌 두 번째 증례에서 병소의 적출술을 시행하였다. Obturator를 3개월 간 장착하여 매복치아의 자발적 맹출을 기대하였으나 맹출 양상이 없어 자가치아이식한 후 MTA를 이용한 근관치료를 하였다. 두 증례 모두 자가치아이식술로 이소매복치를 간단하고 빠르게 치료하였다. 성장하는 환자에게서 이소매복치의 자가치아 이식술은 임플란트나 보철물 수복 대신 좋은 치료 방법이 될 것이다.

Keywords

References

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