매복된 상악 중절치의 교정적 견인을 이용한 치험례 : CASE REPORT = THE FORCED ERUPTION OF IMPACTED MAXILLARY INCISOR

국문 초록 (Abstract)

치아 매복이란 여러 가지 이유로 구강 점막이나 악골내에서 치아가 맹출하지 못하고 있는 상태를 의미한다. 상악 중절치 매복의 원인은 치아종, 과잉치, 공간의 상실, 선행유치의 만기잔존 또는 조기상실, 선행유치의 외상으로 인한 치관이나 치근의 기형, 치배의 이소위치 등이 있다.
매복된 상악 중절치의 경우, 측절치가 빠르게 근심으로 이동하여 공간을 상실하고, 정중선의 변이가 발생하며, 낭종을 형성할 가능성도 있다. 따라서, 매복치의 조기 진단과 그에 따른 적절한 처치가 즉각적으로 이루어져야 한다.
일반적으로 매복의 정도가 심하지 않거나, 각화조직에 의해 매복이 초래된 경우 외과적인 노출만으로도 맹출을 유도할 수 있지만, 외과적인 노출후에 일정기간의 관찰에도 맹출이 되지 않는다거나, 치아의 맹출 방향이 자가 교정될수 없을 정도로 심하게 변위되어 있는 경우, 매복의 위치가 너무 심부에 있는 경우에는 교정적 견인을 시도하는 것이 바람직하다.
본 증례는 매복된 상악 중절치 중 일정기간의 주기적 관찰후 맹출이 기대되지 않았기에, 교정적으로 견인하여 치료하였으며, 치료후 다소의 지견을 얻었기에 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

A tooth impaction means a state that a tooth does not erupt out of oral mucosa or alveolar bone for many reasons. The reasons for an impaction of the Maxillary central incisor are an odontoma, supernumerary tooth, space loss, prolonged remaining or early loss of a preceding deciduous tooth, abnormalities of crown or root caused by trauma of a deciduous tooth and an ectopic position of a tooth germ.
In the case of the impacted maxillary incisor, a rapid mesial movement of a lateral incisor leads a space loss and a midline deviation can be happened. Furthermore, it can cause a cyst. When we treated a patient with an impacted central incisor early, we could see a better prognosis. It means an early diagnosis and an exact treatment are very important.
Generally if the impaction is not severe or it is caused by a keratinized covering tissue, a surgical exposure can induce an eruption easily but an orthodontic force is recommended when an eruption does not happen after a surgical method, when the eruption path is too transpositioned to be corrected spontaneously and when an impacted tooth is located so deeply.
In the treatment using an orthodontic force, careful considerations about a root length, pulp, and a periodontal tissue can improve the periodontal and esthetic prognosis for the long follow-up results.
This case is using an orthodontic traction following a periodic observation and in no expectation of spontaneous eruption. After treatment of this case, I have got some knowledges, so I report this case.

참고문헌 (Reference)

1 "and periodontalconsiderations in the treatment of impacted maxillary central incisors A study of twins" 68-74, 2000

2 "The surgical exposure and application of direct traction of unerupted teeth" 89 : 331-340, 1986

3 "Textbook and color atlas of tooth impaction" Mosby -85, 1997

4 "Repositioning of the gingival margin by extrusion" 122 : 95-102, 2002

5 "Periodontal tissue reactions to orthodontic extrusion An experimental study in the dog" 330-6, 1991

6 "Periodontal status following the alignment of buccally ectopic maxillary canine teeth" 85 : 78-82, 1984

7 "Impacted maxillary canines:a review" 101 : 159-71, 1992

8 "Iatrogenic pulpal reactions to orthodontic extrusion" 99 : 30-34, 1991

9 "Factors related to root resorption in edgewise palatally impacted canines" 85 : 72-7, 1984

10 "Extrusion of the etopic maxillary canine using a lower removable appliance" 107 (107): 349-359, 1995

11 "Extrusion and Alignment of an Impacted Tooth Using Removable Appliances" 36 (36): 379-83, 2002

12 "Contemporary orthodontics" Mosby -484, 2000

13 "Closed-eruption surgical technique for for impacted maxillary incisors:A postorthodontic periodontal evaluation" 122 : 9-14, 2002

14 "Clinical assessment of injuries in orthodontic movement of impacted teeth" 407-18, 1984

15 "Blood flow changes in permanent maxillary canines during retraction" 16 : 1-9, 1994