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치아형태이상을 가진 터너 증후군 환자의 치과적 관리

Dental Management in a Patient with Turner Syndrome with Dental Anomalies : A Case Report

  • 이한이 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 신세영 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 김재곤 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 이대우 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소) ;
  • 양연미 (전북대학교 치의학전문대학원 소아치과학교실 및 구강생체과학연구소)
  • Lee, Haney (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Shin, Seyoung (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Kim, Jaegon (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Lee, Daewoo (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University) ;
  • Yang, Yeonmi (Department of Pediatric Dentistry and Institute of Oral Bioscience, School of Dentistry, Chonbuk National University)
  • 투고 : 2018.03.25
  • 심사 : 2018.05.24
  • 발행 : 2018.08.31

초록

터너 증후군이란 한 개의 X 염색체와 전부 혹은 부분이 결여된 X 염색체를 나타내는 염색체 이상 질환이다. 치근 형태 이상이 터너 증후군 환자에서 정상에서보다 호발한다고 보고되었는데, 치근의 이러한 특징은 근관치료를 까다롭게 만들고, 특수한 처치를 요하기도 한다. 또한 터너 증후군 환자들은 종종 심장 또는 신장의 기형과 같은 전신적인 문제를 동반하기도 하므로, 임상의는 터너 증후군의 특징적인 구내 소견을 인지하고, 사전에 구내 합병증을 예방하기 위해 환자들이 정기적으로 치과 검진을 받을 수 있게 해야 한다. 10세 때에 터너증후군 진단을 받은 12세 여자 환자가 하악 양측 소구치 부위의 불편감을 주소로 내원했다. 특징적으로 하악의 모든소구치에서 우상치와 치외치가 관찰되었다. 하악 양측 제1소구치는 세 개의 치근을, 근단부 병소를 보이는 하악 양측 제2소구치는 두 개의 치근을 가지고 있었다. 근관의 복잡한 해부학적 특징 때문에 치과 현미경을 이용한 적절한 시야를 확보하여 근관치료를 마무리 했다. 2년간의 정기적인 관찰 결과 해당치아와 관련된 임상적 징후나 증상, 치근단 병소는 관찰되지 않았다. 본 증례 보고를 통해 터너 증후군 환자의 구강내 특징과 이의 치과적 관리에 대해 보고하고자 하였다.

Turner syndrome (TS) is a chromosomal disorder caused by monosomy of the X chromosome, with complete or partial absence of the second sex chromosome. Anomalies of root morphology have been found to occur more often in patients with TS, which make endodontic treatment challenging and requires special handling. The patients with TS may also have systematic problems such as cardiac or renal malformations, so in treating these patients it is important for clinicians not only to be aware of the characteristic intraoral findings, but also to make the patients have regular dental check-ups to prevent oral complications in advance. An 12-year-old girl who had been diagnosed with TS at the age of 10 years was referred due to discomfort in the bilateral mandibular premolar regions. Dens evaginatus and taurodontism were detected in all the mandibular premolars characteristically. The bilateral mandibular first premolars had three roots and the bilateral mandibular second premolars had periapical lesion with two roots. Due to the complexity of the root canal anatomy, root canal treatment were completed with a dental microscope to ensure adequate visualization. After 2 years of regular follow-up examinations, there were no clinical sign or symptom associated with the teeth, and no periapical lesion, was found. This case report describes the characteristic oral features and dental management of TS patients.

키워드

참고문헌

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