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.
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.
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, ...
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.
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.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
문제 정의
There have been cases of severe ectopic teeth in which autogenous transplantation would have been a considered as an alternative treatment to implantation and prosthesis. The aim of this study is to describe cases of autotransplantation of fully formed, ectopically impacted teeth.
제안 방법
Autotransplantation was suggested as an alternative and the risks and benefits of the procedure were explained to the patient and her parents, who provided written informed consent. All procedures were performed under nerve block and local anesthesia. The deciduous second molar was extracted, and the impacted tooth was fully luxated.
8B). An incisional biopsy was performed, and the sample was submitted to the Oral Pathology Department at the same center for histopathological evaluation. Based on the histopathology findings, the patient received a definite diagnosis of COC.
5-mm-diameter twist flex wire). Clinical and radiological examinations were performed at 4 weeks and at 3, 6, 9, 12, and 17 months. At the 17-month follow-up, radiographic findings confirmed apical closure in tooth #35 and the formation of an apical barrier and lamina dura, with no root resorption and with complete periapical healing and bone formation (Fig.
Because of the lesion, the left mandibular second molar had submerged to the lower border of the mandible, with its crown embedded in the lesion. Computed tomography (CT) imaging was performed to evaluate the size and location of the lesion (Fig. 7). The preliminary diagnosis of the lesion was a calcifying odontogenic cyst (COC), adenomatoid odontogenic tumor, or calcifying odontogenic epithelial tumor.
7-mm-diameter stainless steel round wire). The patient was prescribed antibiotics (250 mg Augmentin) and a nonsteroidal anti-inflammatory drug (200 mg Carol-F) for 6 days. The patient was instructed to rinse her mouth with 0.
7). The preliminary diagnosis of the lesion was a calcifying odontogenic cyst (COC), adenomatoid odontogenic tumor, or calcifying odontogenic epithelial tumor.
대상 데이터
A 15-year-old boy was referred to the Department of Pediatric Dentistry, Chonnam National University Dental Hospital, with an unerupted left lower second molar and pus discharge around the unerupted region. Intraoral examination revealed an ovoid swelling and pus on the left retromolar pad area (Fig.
1. Preoperative panoramic radiograph of the 13-year-old female patient. The left mandibular second premolar was fully ectopically impacted, and the left mandibular second deciduous tooth was retained.
6. Preoperative panoramic radiograph of the 15-year-old male patient. The radiograph shows a unilocular radiolucent lesion surrounding the crown of the impacted tooth (#37), as well as an irregular radiographic lesion around the upper part of the crown.
성능/효과
With case 1, the periapical radiographs acquired 9 months after surgery revealed a remarkable increase in the radiopacity of the bone. The radiographic findings also revealed a healthy PDL space surrounding the transplanted tooth, the presence of the lamina dura, and apical closure. Although external root resorption was found in case 2, bone regeneration occurred around the transplanted tooth 10 months after surgery.
참고문헌 (15)
Schmidt SK, Cleverly DG : Tooth autotransplantation : an overview and case study. J Mich Dent Assoc, 96:36-41, 2014.
Andreason JO, Paulsen HU, Schwartz O, et al. : A longterm study of 370 autotransplanted premolars. Part II. Tooth survival and pulp healing subsequent to transplantation. Eur J Orthod, 12:14-24, 1990.
Andreasen JO, Paulsen HU, Yu Z, Schwartz O : A long-term study of 370 autotransplanted premolars. Part III. Periodontal healing subsequent to transplantation. Eur J Orthod, 12:25-37, 1990.
Schwartz O, Bergmann P, Klausen B : Autotransplantation of human teeth. A life-table analysis of prognostic factors. Int J Oral Surg, 14:245-258, 1985.
Khetarpal A, Chaudhry S, Talwar S, Verma M : Endodontic management of open apex using MTA and platelet-rich fibrin membrane barrier : A newer matrix concept. J Clin Exp Dent, 5:291-294, 2013.
Kim E, Jung JY, Cha LH, et al. : Evaluation of the prognosis and causes of failure in 182 cases of autogenous tooth transplantation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 100:112-119, 2005.
Andreasen JO : Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys. Int J Oral Surg, 10:43-53, 1981.
Bauss O, Schilke R, Kiliaridis S, et al. : Autotransplantation of immature third molars: influence of different splinting methods and fixation periods. Dent Traumatol, 18:322-328, 2002.
Dohan DM, Choukroun J, Gogly B, et al. : Plateletrich fibrin (PRF): a second-generation platelet concentrate. Part III. leucocyte activation: a new feature for platelet concentrates? Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:51-55, 2006.
Woo SM, Kim WJ, Jung JY, et al. : Combination of mineral trioxide aggregate and platelet-rich fibrin promotes the odontoblastic fifferentiation and mineralization of human dental pulp cells via BMP/Smad signaling pathway. J Endod, 42:82-88, 2016.
Yadav P, Pruthi PJ, Verma M, et al. : Novel use of platelet-rich fibrin matrix and MTA as an apical barrier in the management of a failed revascularization case. Dent Traumatol, 4:328-341, 2015.
AI-Helper
※ AI-Helper는 부적절한 답변을 할 수 있습니다.