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CONTINUED ROOT DEVELOPMENT AFTER AVULSION OF IMMATURE TEETH

미성숙 영구치의 탈구성 외상 이후 계속된 치근 성장

  • Lee, Ju-Eun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Young-Jin (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Jung (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University) ;
  • Nam, Soon-Hyeun (Department of Pediatric Dentistry, School of Dentistry, Kyungpook National University)
  • 이주은 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김영진 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 김현정 (경북대학교 치의학전문대학원 소아치과학교실) ;
  • 남순현 (경북대학교 치의학전문대학원 소아치과학교실)
  • Received : 2013.01.10
  • Accepted : 2013.05.14
  • Published : 2013.05.31

Abstract

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

외상에 의한 미성숙 영구치의 손상은 유치열에서 영구치열로 이환되는 8~10세경에 가장 빈발하며 전체 외상 환자의 높은 빈도를 차지한다. 외상에 대한 결과는 치아의 파절, 전위, 함입, 정출, 탈구 등의 경조직 손상 뿐 아니라 치수, 치주인대, Hertwig 상피 근초, 치조골, 치은 및 구강점막 등의 치아 인접조직의 손상도 포함한다. 일반적으로 Hertwig 상피 근초는 외상성 손상에 취약하지만, 때때로 감염이나 외상에 의한 손상을 견디고 생활력을 유지하여 치근성장에 대한 정상적인 기능을 수행하는 것이 보고된 바 있다. 본 증례에서는 외상에 의해 완전 탈구된 미성숙 영구치를 가진 두 명의 환자에 대해 보고하고자 한다. 첫 번째 환자의 경우 탈구된 상악 중절치를 재식하였고 두 번째 환자의 경우 탈구된 하악 중절치를 재식하지 않았다. 하지만 두 환자 모두에서 탈구된 치아의 치조와 부위에 분리된 치근의 계속적인 성장을 보이는 바 이를 보고하고자 하며, 나아가 계속적인 치근형성에 있어서 미성숙 치수 조직과 Hertwig 상피 근초의 생활력 보존이 결정적임을 알리고자 한다.

Keywords

References

  1. Andreasen JO, Andreasen FM, Andersson L : Textbook and color atlas of traumatic injuries to the teeth, 4th edn. Blackwell Munksgaard, Copenhagen, Denmark 2007.
  2. Andreasen JO, Ravn JJ : Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg, 1:235-9, 1972. https://doi.org/10.1016/S0300-9785(72)80042-5
  3. Huang GT, Sonoyama W, Shi S, et al. : The hidden treasure in apical papilla : the potential role in pulp / dentin regeneration and bioroot engineering. J Endod, 34:645-51, 2008. https://doi.org/10.1016/j.joen.2008.03.001
  4. Andreasen JO, Borum MK, Andreasen FM : Replantation of 400 avulsed permanent incisors. 3. Factors related to root growth. Endod Dent Traumatol, 11:69-75, 1995. https://doi.org/10.1111/j.1600-9657.1995.tb00463.x
  5. Gibson AC : Continued root development after traumatic avulsion of partly-formed permanent incisor. Br Dent J, 126:356-7, 1969.
  6. Barker BC, Mayne JR : Some unusual cases of apexification subsequent to trauma. Oral Surg Oral Med Oral Pathol, 39:144-50, 1975. https://doi.org/10.1016/0030-4220(75)90405-3
  7. Burley MA, Reece RD : Root formation following traumatic loss of an immature incisor: a case report. Br Dent J, 141:315-6, 1976. https://doi.org/10.1038/sj.bdj.4803843
  8. Smith BE, Thaler MN : Detached root apexogenesis. Oral Surg Oral Med Oral Pathol, 73:129, 1992. https://doi.org/10.1016/0030-4220(92)90173-N
  9. Welbury R, Walton AG : Continued apexogenesis of immature permanent incisors following trauma. Br Dent J, 187:643-4, 1999.
  10. Rule DC : Some considerations in the clinical management of traumatised permanent incisors with immature roots. Proc Br Paedod Soc, 3:33-5, 1973.
  11. Cvek M : Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. Endod Dent Traumtol, 8:45-55, 1992. https://doi.org/10.1111/j.1600-9657.1992.tb00228.x
  12. Jung IY, Kim ES, Lee CY, Lee SJ : Continued development of the root separated form the main root. J Endod, 37:711-4, 2011. https://doi.org/10.1016/j.joen.2011.01.015
  13. Ten Cate AR : A fine structural study of coronal and root dentinogenesis in the mouse : observation on the so-called' von-Korff fibers'and their contribution to mantle dentin. J Anat, 125:183-97, 1978.
  14. Sonoyama W, Seo BM, Yamaza T, Shi S : Human Hertwig's epithelial root sheath cells play crucial roles in cementum formation. J Dent Res, 86:594-9, 2007. https://doi.org/10.1177/154405910708600703
  15. Sonoyama W, Liu Y, Wang S, et al. : Mesenchymal stem cell-mediated functional tooth regeneration in swine, PloS One, 1:e79:1-8, 2006. https://doi.org/10.1371/journal.pone.0000079
  16. Sonoyama W, Liu Y, Huang GT, et al. : Characterization of the apical papilla and its residing stem cells from human immature permanent teeth: a pilot study. J Endod, 34:166-71, 2008. https://doi.org/10.1016/j.joen.2007.11.021
  17. Greer JM, Moule AJ, Greer PJ : Resumed tooth development following avulsion of a permanent central incisor. Int Endod J, 29:266-70, 1996. https://doi.org/10.1111/j.1365-2591.1996.tb01380.x
  18. Yang SF, Yang ZP, Chang KW : Continuing root formation following apexification treatment. Endod Dent Traumatol, 6:232-5, 1990. https://doi.org/10.1111/j.1600-9657.1990.tb00425.x
  19. Arrow P : An unusual healing of a replanted permanent lateral incisor. Aust Dent J, 54:57-60, 2009. https://doi.org/10.1111/j.1834-7819.2008.01090.x