MANAGEMENT OF INFRAOCCLUDED MANDIBULAR SECOND PRIMARY MOLARS: CASE REPORT

저위교합된 제 2유구치에 대한 치험례

  • Kwak, So-Youn (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Ki-Tae (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Ji-Yeon (Department of Pediatric Dentistry, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 곽소연 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과) ;
  • 박기태 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과) ;
  • 김지연 (성균관대학교 의과대학 삼성서울병원 치과진료부 소아치과)
  • Published : 2009.08.31

Abstract

An infraoccluded tooth is a tooth that has failed to erupt to be in line with adjacent teeth in the vertical plane of occlusion. Multiple complications can occur as a result of an infraoccluded tooth. Tipping of neighboring teeth, loss of space opposing teeth elongation, increased susceptibility to dental caries and abnormal eruption path, impaction and rotation of permanent successor are the consequences of infraocclusion of primary molar. Therefore, early diagnosis and treatment is the key to prevent the complications. Treatment options can be periodic follow-up, temporary restoration or extraction of the infraoccluded tooth depending on the presence of the successor, the extent of infraocclusion and the extent of tilting of the neighboring teeth. The infraoccluded primary molars with permanent successors present tend to exfoliate normally. However, failure to do periodic check up of the infraoccluded teeth may lead to serious complications. In these cases, surgical extractions are often necessary after space regaining and space maintainers should be placed until the eruption of the permanent successors are completed.

저위교합이란 치아가 출은한 이후 유착 등의 원인으로 맹출이 정지되어 주위 인접치 보다 교합평면이 낮아지는 것을 말한다. 저위교합은 인접치들의 경사, 저위교합된 부위의 공간상실, 대합치의 정출, 해당부위 치아우식 감수성의 증가, 후속 영구치의 맹출경로 변위, 매복, 회전 등의 문제점을 유발할 수 있으므로 조기 진단 및 정기검진을 통한 적절한 치료가 필요하다. 저위교합된 유구치는 대부분 영구 계승치가 존재하며 일반적으로 정상 탈락한다. 그러나 저위교합된 유구치의 탈락이 지연되고 저위교합의 정도가 심화되어 해당부위의 공간상실이 발생하면, 공간부족으로 인하여 후속 영구치의 매복을 야기할 수 있다. 이러한 경우 교정적으로 공간확장술을 시행한 후 외과적 발치를 고려해야 한다. 본 증례는 하악 제 2유구치의 저위교합이 관찰된 3명의 환아를 대상으로 공간에 대한 평가 후 필요한 경우 공간확장술을 시행하고 발치를 시행함으로써 저위교합으로 인해 발생된 문제점을 개선하고, 추후에 발생될 합병증을 예방하였기에 이를 보고하는 바이다.

Keywords

References

  1. Kurol J, Magnusson BC : Infraocclusion of primary molars: a histologic study. Scand J Dent Res, 92:564-576, 1984.
  2. Noble J, Karaiskos N, Wiltshire WA : Diagnosis and management of the infraerupted primary molar. Br Dent J, 203:632-634, 2007. https://doi.org/10.1038/bdj.2007.1063
  3. Via WF : Submerged Deciduous Molars : Familial Tendencies. J Am Dent Assoc, 69:127-129, 1964.
  4. Steigman S, Koyoumdjisky KE, Matrai Y : Submerged deciduous molars and congenital absence of premolars. J Dent Res, 52:842, 1973 https://doi.org/10.1177/00220345730520043301
  5. Raghoebar GM, Boering G, Stegenga B, et al. : Secondary retention in the primary dentition. ASDC J Dent Child, 58:17-22, 1991.
  6. Krakowiak FJ : Ankylosed primary molars. ASDC J Dent Child, 45:288-292, 1978.
  7. Messer LB, Cline JT : Ankylosed primary molars : results and treatment recommendations from an eight-year longitudinal study. Pediatr Dent, 2:37-47, 1980.
  8. Andlaw RJ : Submerged deciduous molars. A review with special reference to the rationale of treatment. J Int Assoc Dent Child, 5:59-66, 1974.
  9. Silling G, Keller JG, Feingold M : Retained primary teeth: their effect on developing occlusions. ASDC J Dent Child, 46:296-299, 1979.
  10. Adams TW, Mabee ME, Browman JR : Early onset of primary molar ankylosis : report of a case. ASDC J Dent Child, 48:447-449, 1981.
  11. Kurol J, Koch G : The effect of extraction of infraoccluded deciduous molars : A longitudinal study. Am J Orthod, 87:46-55, 1985. https://doi.org/10.1016/0002-9416(85)90173-3
  12. Kurol J : Infraocclusion of primary molars: an epidemiologic and familial study. Community Dent Oral Epidemiol, 9:94-102, 1981. https://doi.org/10.1111/j.1600-0528.1981.tb01037.x
  13. Biederman W : Etiology and treatment of tooth ankylosis. Am J Orthod, 48:671-684, 1962.
  14. Runin PL, Biederman W : Attempt to produce tooth ankylosis. J Dent Res, 40:744, 1961.
  15. Biederman W : The problem of the ankylosed tooth. Dent Clin North Am, 12:409-424, 1968.
  16. Becker A, Karnei RM, Steigman S : The effects of infraocclusion : Part 3. Dental arch length and the midline. Am J Orthod Dentofacial Orthop, 102:427-433, 1992. https://doi.org/10.1016/S0889-5406(05)81189-8
  17. Teague AM, Barton P, Parry WJ : Management of the submerged deciduous tooth: 2. Treatment. Dent Update, 26:350-352, 1999.
  18. Brearley LJ, McKibben DH : Ankylosis of primary molar teeth. I. Prevalence and characteristics. ASDC J Dent Child, 40:54-63, 1973.
  19. Ekim SL, Hatibovic KS : A treatment decision-making model for infraoccluded primary molars. Int J Paediatr Dent, 11:340-346, 2001. https://doi.org/10.1046/j.0960-7439.2001.00294.x
  20. Kurol J, Thilander B : Infraocclusion of primary molars and the effect on occlusal development, a longitudinal study. Eur J Orthod, 6:277-293, 1984.
  21. 방석윤, 김은정, 김현정 등 : 저위교합 유구치에서의 공간 확장술을 이용한 외과적 접근. 대한소아치과학회지, 32:531-536, 2005.
  22. 이창윤, 김신 : 저위교합 유구치에 관한 임상적 고찰. 대한소아치과학회지, 22:469-474, 1995.
  23. Nazif MM, Zullo T, Paulette S : The effects of primary molar ankylosis on root resorption and the development of permanent successors. ASDC J Dent Child, 53:115-118, 1986.