Supernumerary deciduous teeth with multiple maxillary impacted mesiodens: A case report

Maxillary impacted mesiodens are frequently encountered in pediatric dentistry. Much research has been conducted concerning their incidence, position, and form. Supernumerary teeth erupting in the primary dentition with maxillary impacted mesiodens are very rare. In January 2011, a nine-year-old boy presented for dental treatment and was found to have supernumerary deciduous teeth. Upon panoramic radiography, multiple impacted mesiodens were found; therefore, computed tomography (CT) was performed for further examination. One month later, the boy was referred to our department for extraction of the deciduous supernumeraries and impacted mesiodens. We suspected that these supernumeraries, mesiodens, and remaining primary teeth would lead to problems with the eruption of the permanent teeth. Therefore, by ascertaining the exact position of the mesiodens and the successional permanent teeth using CT, extraction was performed under general anesthesia in March 2011 without any error. Six months postoperatively, panoramic radiographs showed no superfluous structure that appeared to be a tooth. We suggest that when multiple maxillary impacted mesiodens are found, their exact positions can be located using CT before extraction.     

上颌埋伏尖牙非手术助萌的正畸治疗

[摘要] 目的 探讨上颌埋伏尖牙非手术助萌正畸治疗的适应证及其临床效果。方法 选取10～15岁上颌埋伏尖牙患者20例,应用螺旋CT三维重建技术对其进行诊断,明确埋伏尖牙颌骨内位置、方向及牙根发育情况,选取适合病例12例通过正畸手段为埋伏尖牙开辟间隙,等待其自行萌出;8例采用外科翻瓣导萌术牵引导萌。结果 12例非手术助萌患者,正畸拓展足够间隙后经3～10个月上颌埋伏尖牙均自行萌出至正常位置,牙周附着健康;8例外科手术导萌患者,上颌埋伏尖牙正畸牵引到位后均有不同程度的牙周附着丧失,影响龈缘美观。结论采用螺旋CT三维重建技术可以立体直观的提供埋伏尖牙的信息,为临床医师明确诊断及制定治疗方案提供依据,减少手术适应证,使用非手术助萌的方法可使上颌埋伏尖牙自行萌出,避免手术创伤痛苦,萌出后牙周附着好。     

正畸治疗诱导阻生上颌尖牙的自发萌出

目的 探讨阻生上颌尖牙正畸治疗诱导自发萌出的方法,总结合适的临床处理策略,为阻生尖牙的合理治疗提供依据.方法 选择13例恒牙列患者(男6例,女7例)的17颗阻生上颌尖牙,通过正畸治疗在相应牙弓位置为尖牙预留充足的间隙,待其自发萌出后直接粘结矫正装置排入牙列正常位置.结果 预留间隙2～24个月后阻生尖牙自发萌出,治疗后尖牙及邻牙牙周状况良好.结论 当阻生尖牙错位不严重,扩弓或减数拔牙即能为阻生尖牙提供足够萌出间隙,判断其能自行萌出时,可采取正畸诱导自萌的方法进行治疗.     

不同年龄组上颌埋伏阻生尖牙正畸牵引的疗效比较

目的:比较成人与青少年上颌埋伏阻生尖牙患者,采用正畸牵引治疗的成功率及其治疗所需时间的差异。方法:选择17例成人和17例青少年患者各21颗上颌埋伏阻生尖牙,2组上颌埋伏阻生尖牙在三维CT片上的位置、三维方向和埋伏阻生程度均相似。对2组正畸牵引治疗的成功率及其治疗所需时间进行比较,分别采用χ2检验和配对t检验进行统计学处理。结果:成人组正畸牵引治疗的成功率为85.71%,青少年组为100%,两者存在显著的差异(P<0.01)。正畸牵引治疗所需时间,成人组长于青少年组,有显著差异(P<0.001)。结论:正畸加开窗牵引上颌埋伏阻生尖牙的成功率,成人组显著低于青少年组,且正畸牵引治疗所需时间也显著长于青少年组。     

上颌乳尖牙双根1例

乳尖牙双根属于牙齿发育异常的一种,在临床上极为罕见,上颌发生率较下颌多,且多为双侧发生.本文报道1例上颌双侧乳尖牙双根病例,并对相关文献进行回顾.     

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目的：探讨阻生上颌尖牙合适的临床处理策略,为其合理治疗提供依据。方法回顾2000-2012年期间在大连市口腔医院正畸科接受治疗的35例阻生上颌尖牙病例的临床资料,总结分析尖牙阻生状况及相应的治疗措施和疗效。临床处理方法包括拔除、助萌和导萌。结果拔除2例;只做正畸治疗的助萌法16例,留出足够间隙后等待阻生尖牙自行萌出,观察时间5～24个月,均取得良好治疗效果,矫治后阻生尖牙牙龈形态及牙根状况良好;正畸附加外科手术牵引的导萌法17例,除1例21岁男性患者外,其余16例均牵引到位,但矫治后部分阻生尖牙牙龈形态不如助萌法矫治后。结论当阻生上颌尖牙牙体严重畸形、根弯曲短小及高位近远中向横位阻生时考虑拔除;阻生上颌尖牙近远中向错位不严重,扩弓或减数拔牙即可为阻生尖牙留出足够萌出间隙,判断其能自然萌出时首选助萌法;阻生上颌尖牙近远中向错位严重或阻生尖牙已伤及邻牙牙根、仅用正畸治疗无法去除阻生尖牙萌出障碍时采用导萌法,导萌术后的牵引需注意控制牵引方向及大小,要避免伤及邻牙牙根,尽量使阻生牙从附着龈萌出,有利于形成良好的牙龈形态。     

上颌阻生尖牙患者寰椎形态变异情况的锥形束CT研究

目的 利用锥形束CT(cone-beam computed tomography,CBCT)研究上颌尖牙唇(腭)侧阻生(BIC/PIC)的患者寰椎形态变异的发生情况,以期辅助上颌阻生尖牙的预测和早期干预。方法 选取196例上颌阻生尖牙患者(研究组)和196例年龄、性别、安氏分类与之相匹配的尖牙正常萌出者(对照组)。将所有样本的CBCT导入Dolphin软件,重建头颅侧位片和三维图像,观察并记录各组寰椎后桥及寰椎后弓发育缺陷(包括寰椎后弓发育不全和寰椎后椎弓裂隙)的发生情况,并使用SPSS软件进行统计分析。结果 研究组寰椎后桥的发生率为32.6%,显著高于对照组(22.4%,P=0.024)。PIC组寰椎后桥发生率显著高于对照组(P=0.005),BIC组和对照组、BIC和PIC组之间无统计学差异(P>0.05)。寰椎后弓发育缺陷研究组和对照组之间的发生率并无统计学差异(P>0.05)。结论 上颌尖牙阻生患者较尖牙正常萌出者更容易发生寰椎后桥。     

Permanent maxillary canines – review of eruption pattern and local etiological factors leading to impaction

The position of the permanent maxillary canine at the angle of the mouth is strategically significant in maintaining the harmony and symmetry of the occlusal relationship. However, the maxillary canine is the second most frequently impacted tooth, with prevalence reported to be between 1% and 2%. Moreover, treatment of this condition is often complex and involves substantial time and financial cost. Hence, it is only prudent to monitor the eruption and identify the etiological factors that lead to impaction of the maxillary canine. Numerous researchers have tried to identify specific and nonspecific etiological factors responsible for displacement of canines. The purpose of this review was to track the development processes of maxillary canines and determine the hindrances that affect the eruption at different ages. Awareness of the eruption process and etiology of noneruption will help to reduce the incidence of impacted canines by allowing for early recognition and interceptive treatment.     

上颌尖牙埋伏阻生的临床分析

目的对上颌尖牙埋伏阻生的患病特点及治疗结果进行分析,以期为临床治疗上颌尖牙埋伏阻生提供参考数据。方法在北京大学口腔医学院·口腔医院正畸科门诊2001年1月至2005年1月期间诊治的10505例错(牙合)畸形患者中,经CT检查选出上颌尖牙埋伏阻生患者215例(汉族),共有埋伏阻生尖牙248颗。统计上颌尖牙埋伏阻生在正畸患者中所占比例,χ~2检验分别比较患者性别、唇腭侧阻生以及相应治疗情况的差异。结果上颌尖牙埋伏阻生在正畸门诊患者中约占2．05%,女性：男性为1．8∶1,唇侧：腭侧为2．1∶1。“外科手术暴露+正畸牵引”的方式在治疗中占主导地位。“外科手术拔除”的治疗方式在腭侧埋伏阻生尖牙中的应用多于唇侧,差异有统计学意义(P＜0.01)。结论本组患者上颌尖牙埋伏阻生以女性、唇侧多见,临床对唇腭侧尖牙埋伏阻生的治疗存在一定差异。     

异位尖牙自体移植的5年临床效果研究

目的 对正畸牵引困难的异位尖牙,应用牙种植外科技术结合正畸治疗进行尖牙移植,评价其软组织美学及长期效果.方法 对9位患者10例正畸牵引困难的异位尖牙行移植术.其中,男性4名,女性5名;年龄13岁～37岁,平均19.8岁.尖牙埋伏阻生8例,异位萌出2例;上颌7例,下颌3例.术前正畸,调整受植牙区近远中间隙.应用牙种植技术预备受植床,骨引导再生技术修复骨缺损及稳定移植牙.术后正畸排齐牙列.定期随访.临床检查评价牙龈软组织美学、牙及牙周组织状态.影像学检查评价牙根、根周膜及硬骨板状况.结果 所有病例随访2年～9年,平均5.1年.牙龈软组织美学评分13.33±0.87.牙周袋深度均小于3 mm.牙髓电活力测试正常4例.影像学检杳显示,根周膜间隙正常及硬骨板连续7例,根周间隙模糊2例,牙根替代性吸收1例.结论 本研究提示,结合牙种植外科技术和正畸治疗的异位尖牙移植,为正畸牵引困难尖牙提供了美学效果和长期效果良好的治疗选择.

Abstract：

Objective To evaluate the esthetics and outcome of the ectopically positioned canines treated with autotransplantation and orthodontics. Methods Ten ectopic canines in 9 consecutive patients (4 female, 5 male; mean age 19. 8 years, range 13～37 years) were included.Eight of them were deeply impacted and two canines were ectopically erupted (7 maxillary and 3 mandibular canines). The space of recipient site was created orthodontically before surgery. The recipient socket was prepared with dental implant surgery system. After transplantation, bone defect was grafted with guided bone regeneration (GBR) technique. Postoperative orthodontic treatment was carried out. Patients were followed up every 6 months. The pink esthetic score was evaluated.Periodontal pocket depth was measured. Pulpal vitality was assessed. Periapical radiograph was taken to evaluate root resorption, periodontal space and lamina dura. Results The average follow-up period was 5. 1 years (range 2～9 years). The pink esthetic score was 13. 33±0. 87. All pocket depth was less than 3 mm. Radiographic examination showed uninterrupted periodontal space and lamina dura in 7 cases, unclear periodontal space in 2 cases and replacement resorption in 1 case. Conclusions Autotransplantation of the ectopically positioned canines with the combination of dental implant surgical techniques and orthodontics could be suggested as an esthetic and predictable treatment modality.     

上颌腭侧埋伏阻生尖牙的研究进展

上颌尖牙腭侧埋伏阻生在临床上很常见,它会影响上颌牙列的功能和美观。为消除上颌尖牙腭侧埋伏阻生对牙颌生长发育的不利影响,应对其进行早期诊断并选择正确的治疗方法。本文就上颌腭侧埋伏阻生尖牙的发病率、病因、诊断、临床治疗方法以及预后等作一综述。     

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目的    探讨固定矫治技术矫治上颌前牙埋伏阻生临床效果。方法    选取2006—2008年就诊于江苏省泰州市人民医院口腔医学专科的13例14颗上颌前牙埋伏阻生的正畸患者,采用固定矫治技术轻力牵引导萌进行矫治。结果    12例患者13颗埋伏上颌前牙被牵引入正常牙列。结论    在上颌前牙埋伏阻生的患者中,采用固定矫治技术,既保存了患牙,改善美观,又防止形成牙源性囊肿的可能,是一种较理想的矫治方法。     

Bilateral congenitally missing maxillary canines. A case report

Exclusive aplasia of maxillary permanent canines is extremely rare. There are only a few cases of this condition reported in the literature. This paper reports a case of bilateral congenitally missing canines in a healthy 11 year old male of Chinese origin. The article discusses problems in diagnosis and presents options in the management of such a case. The management option selected was the most appropriate for the family at the time of presentation.     

Reducing the incidence of palatally impacted maxillary canines by extraction of deciduous canines: a useful preventive/interceptive orthodontic procedure. Case reports

The early detection of palatally impacted permanent maxillary canines is stressed. Appropriate radiographs to determine impactions are suggested and removal of deciduous canines to eliminate impactions in patients who have good dental arches with no space deficiency is recommended. Two case histories are presented to illustrate the method.     

Autotransplantation of maxillary canine following removal of compound odontome: a case report

Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral permanent canine (13) and premolars (14 and 15) have erupted. Upon radiographic examination, a mass which was diagnosed later to be compound odontome was detected. The treatment consisted of surgical removal of the odontome, extraction of the primary canine (63) and left permanent canine (23), and transplantation of the permanent canine (23). The management of this case and the literature related to autotransplantation are discussed.     

Intra-alveolar surgical uprighting of impacted teeth: a case report

Abstract Although orthodontic repositioning of impacted teeth is widely used, the treatment has its limitations. Autotransplantation or intra-alveolar surgical repositioning of teeth is an alternative therapy that may be used in selected cases of desperate impactions, when orthodontic extrusion is unsuccessful or when orthodontic treatment is rejected by the patient. A case report is presented to stress both the indications and limitations of a modified technique of intra-alveolar surgical uprighting of impacted teeth.     

A clinical and radiologic study of autotransplanted impacted canines

The aim of the present study was to evaluate the clinical and radiologic results of 20 autotransplantations of impacted canines performed in the Orthodontic and Pedodontic Department of the University of Geneva between 1979 and 1988. The sample, divided into two different age groups (group A: 13–20 years; group B: 20–48 years), demonstrated persistence of pulp vitality in 80% of the cases in group A, whereas routine endodontic treatment was instituted in all cases of group B. Periodontal healing was noted in 90% of the cases in group A, and in 70% of the cases in group B. The present clinical and radiologic data indicate that impacted canines can be transplanted at any age with good prognosis and are an alternative to orthodontic repositioning in selected cases of canine impaction.