埋伏阻生牙曲面断层片诊断方案的探讨

目的 :探讨对于颌骨不同部位的埋伏阻生牙应用不同平片透照技术以达到精确直观的X线影像 ,提高诊断的准确率。方法 :对32例埋伏阻生牙及多生牙患者使用牙片、咬合片、全景片、全景断层片、头颅侧位片、埋伏牙切线位片、全景上颌窦侧方片对埋伏阻生牙定位。结果 :通过单全景、双曲面断层及多断层三种曲面断层片诊断方案埋伏阻生牙及多生牙在颌骨中的位置 ,牙轴的方向 ,牙体形态、与周围解剖组织的关系得以准确显示。结论 :本研究平片诊断方案能比较准确地对颌骨内埋伏阻生牙及多生牙定位 ,为正畸及口外治疗方案的确定提供可靠依据。     

上颌埋伏多生牙的定位与临床治疗分析

目的 探讨埋伏多生牙的定位与手术处理.方法 选取门诊患者79例,通过定位X线牙片、上颌骨侧位断层片及螺旋CT结合临床检查,分析判断埋伏牙的位置,选择合适的处理方法.结果 79例患者经术前定位,用根尖片水平定位者58例,采用颌骨侧位断层片定位者11例,采用螺旋CT定位者5例,术前判断均与术中所见一致.根据患者不同特点采用相应麻醉方法,依术前定位采用相应的手术入路,所有多生牙均顺利拔除.结论 定位X线牙片、上颌骨侧位断层片单独应用,必要时结合螺旋CT,可以对埋伏多生牙进行精确定位,选择合适的手术入路及麻醉方法,利于多生牙的拔除.     

颌骨侧位曲面断层片在上颌骨埋伏多生牙定位中的应用:25例报道

目的：探讨全景机颌骨侧位曲面断层片在上颌骨埋伏多生牙定位中的应用价值。方法：对25例上颌骨埋伏多生牙患者采用ORTHOPHS全景机行侧位曲面断层片，分析、判断埋伏多生牙的位置，采取不同的手术径路拔除埋伏多生牙。结果：(1)颌骨埋伏多生牙侧位曲面断层定位精确；(2)颌骨侧位曲面断层能显示牙弓与多生牙的关系：(3)颌骨侧位曲面断层片能显示多生牙的牙体及牙根的形态。结论：颌骨侧位曲面断层片对颌骨埋伏多生牙的定位具有重要价值。     

以上下颌牙切线位X线片定位埋伏多生牙的效果探讨

目的:探索埋伏多生牙定位的有效方法.方法:对临床58 例埋伏多生牙摄上下颌牙切线位X线片定位,同时与定位牙片及定位断层片的定位效果进行比较.结果:上下颌牙切线位X线片定位的准确率为93.1%,定位牙片为37.9%,定位断层片为43.1%,差异明显.结论:上下颌牙切线位X线片是埋伏多生牙定位的有效方法,图像直观、全面,而且经济、实用.     

导杆式矫治器治疗上颌唇侧倒置埋伏中切牙

目的:探讨导杆式矫治器治疗上颌唇侧倒置埋伏阻生中切牙的临床效果及治疗作用。方法:术前拍摄曲面断层片、头颅侧位片及CBCT明确诊断和定位患牙,用导杆式矫治器对16例上颌唇侧倒置埋伏中切牙进行外科-正畸联合治疗。固定保持1年后,拍CBCT评价远期疗效。测量矫治后埋伏牙和对侧同名牙的根长,用SPSS17.0软件进行配对t检验。结果:16例唇侧倒置埋伏中切牙均牵引入牙列排齐,牙髓和牙周状况良好。保持1年后X线及临床检查示埋伏牙均正常。埋伏牙的根长(8.32±1.70)mm短于对侧同名牙(10.12±1.71)mm(P<0.001)。结论:对未成年患者应保留上颌埋伏中切牙;导杆式矫治器是治疗上颌唇侧倒置埋伏中切牙的一种有效方法。     

埋伏阻生牙不同平片诊断方案的探讨

目的 :探讨对于颌骨不同部位的埋伏阻生牙应用不同平片透照技术以达到精确直观的X线影像 ,提高诊断的准确率。方法 :对 3 2例埋伏阻生牙及多生牙患者使用曲面断层片、直线断层片对埋伏阻生牙定位。结果 :通过曲面断层、直线断层及曲面结合直线断层 3种断层片诊断方案可较好的判断埋伏阻生牙及多生牙在颌骨中的位置、牙轴的方向、牙体形态、与周围组织的解剖关系。抽取 5例经手术验证 ,与X线片判别位置一致。结论 :直线断层平片诊断方案能比较准确、直观地对颌骨内埋伏阻生牙及多生牙定位 ,无需常用定位方法中考虑埋伏阻生牙相对参照牙移动的距离 ,球管移动的方向。     

纵向断层摄影术在儿童前牙区埋伏多生牙拔除中的应用

童上颌前牙区埋伏多生牙发生率为0.47%～ 2.6%[1],常常影响儿童上前牙的萌出和排列,常规治疗方法是手术拔除.手术前埋伏多生牙的定位对指导手术入路至关重要.我们采用综合摄片法,将根尖片或曲面断层片与纵向多层断层片联合运用,进行埋伏多生牙的定位,并结合临床实际分析纵向断层摄影术在儿童前牙区埋伏多生牙拔除中的应用效果.     

X线头影测量片在上颌骨前部埋伏阻生齿定位中的应用

临床上上颌骨前部埋伏牙包括埋伏多生牙和埋伏阻生的恒牙,主要治疗方法是手术治疗,由于埋伏牙多发生于替牙期儿童,颌骨内既有多生牙又有未发育完成的恒牙,X片定位显得非常重要.作者自2002年以来,应用X线头影测量片对上颌骨前部埋伏阻生齿进行分析定位后手术治疗,共治疗287例,只有1例判断失误,准确率达99.65%,效果满意,现报告如下.     

静脉麻醉下儿童埋伏多生牙拔除的临床总结

目的:探讨在浅静脉麻醉下儿童埋伏多生牙拔除的临床技术要点。方法:对62例埋伏多生牙患儿(7～12岁),经X线检查术前定位后,在异丙酚、芬太尼静脉麻醉下实施牙拔除术。结果:62例埋伏多生牙均在静脉麻醉下顺利拔除。结论:静脉麻醉可以使手术平稳实施,术后可以很快离院,有利于儿童埋伏牙的拔除。     

锥形束CT在治疗上颌前牙区埋伏牙中的应用

目的:探讨锥形束CT(CBCT)在治疗上颌前牙区埋伏牙中的临床应用价值。方法:收集我院2009—2010年经普通X线片确定有埋伏牙,但不易具体定位的患者11例,进行CBCT扫描和三维重建,确定埋伏牙在颌骨内的具体位置。结果:经CBCT扫描、三维重建后,所有患者均可直观再现埋伏牙的形态、数目、在颌骨中的具体位置和发育情况。11例患者共16颗埋伏牙,其中既有埋伏阻生牙又有埋伏多生牙,3例(4颗)为埋伏多生牙,1例有2颗埋伏牙;2例为倒置埋伏,2例为水平埋伏,3例为垂直埋伏,4例为斜位埋伏。根据CBCT结果制订治疗方案,获得满意的治疗效果。结论:CBCT三维重建对于上颌前牙区埋伏牙治疗方案的设计及实施具有重要意义。     

Orthodontic treatment for an unerupted and severely rotated maxillary central incisor. A case report.

BACKGROUND: Many reports have indicated the treatment for permanent teeth with disturbed eruption due to the presence of supernumerary teeth. However, successful treatment for an unerupted maxillary incisor with severe rotation and another maxillary incisor with disturbed eruption by a supernumerary tooth is quite rare. CASE REPORT: We treated a 7-year-old Japanese male with an unerupted and severely rotated maxillary right incisor, along with a maxillary left incisor due to interference with eruption by an inverted supernumerary tooth. Orthodontic treatment using surgical exposure, traction and guidance of the rotated right incisor, and maxillary expansion following extraction of the supernumerary tooth were performed. FOLLOW-UP: At 27 months following extraction of the supernumerary tooth, and comprehensive orthodontic treatment led the malposititioned central incisors to a functional position and stable occlusion.     

Retrospective analysis of factors influencing the eruption of delayed permanent incisors after supernumerary tooth removal.

AIM: This was to assess the predictability of eruption of delayed permanent incisors after supernumerary removal and creation of adequate space, in relation to: root maturity, degree of vertical impaction, and degree of angulation of impaction. METHODS: The dental records of children with supernumerary teeth delaying the eruption of permanent incisors were analysed. The type of a supernumerary tooth, its location and position were recorded, along with the stage of root maturation, angulation and vertical distance of impaction of the permanent incisor. At the initial surgery, the unerupted supernumerary tooth and any retained primary incisors were removed. The unerupted permanent incisor was not exposed. If necessary, the maxillary primary canines were removed to create sufficient space for eruption of the delayed permanent tooth. A secondary surgical procedure was planned after 18 months if there was no significant progress of the permanent tooth towards eruption. STATISTICS: All data were entered onto a Microsoft Excel spread sheet and analysed using Fisher's Exact Tests throughout due to the small numbers. RESULTS: Sixty-six supernumerary teeth were removed, 22 from boys and 44 from girls with ages ranging from 6 to 10 years 6 months at the time of surgery. Primary canines were extracted in 59.1% of cases. Spontaneous eruption occurred in 89.4% of delayed permanent teeth. The mean time to eruption was 9.2 months (median = 7 months). There was no statistically significant association between tooth eruption and root maturity or the degree of vertical impaction. There was an association between eruption and the degree of the angle of impaction of the permanent incisor (p<0.05). CONCLUSION: The majority of delayed permanent teeth erupt spontaneously if sufficient space is available or created at the time of removal of the unerupted supernumerary. The angulation of impaction of the permanent incisor is associated with a delay in eruption.     

A case report of cleidocranial dysplasia: A noninvasive approach

Cleidocranial dysplasia (CCD) is a rare bone disorder. The main dental features are the presence of multiple retained deciduous teeth and supernumerary teeth, as well as unerupted permanent teeth. To date, CCD is managed by a combination approach, which consists of the extraction of deciduous and supernumerary teeth, followed by orthodontic traction of unerupted permanent teeth. This case highlights the management of a girl with CCD, who refused the recommended protocol. A 15‐year‐old Malay female presented with a complaint of retained deciduous teeth. Intraoral examination revealed multiple retained deciduous teeth. Radiographs showed numerous impacted supernumerary and unerupted permanent teeth. The patient opted to improve her facial appearance with a less aggressive treatment option. A composite build‐up on all anterior maxillary deciduous teeth was carried out until the patient was ready to undergo surgical intervention.     

Progressive development of supernumerary teeth in cleidocranial dysplasia

A 9-year-old boy suffering from cleidocranial dysplasia presented with multiple unerupted permanent teeth and five unerupted supernumerary teeth. During a 4-year observation and treatment period he developed nine more supernumerary teeth at a time when normally new teeth would no longer be forming. By the age of 13 years and 5 months a total of fourteen supernumerary teeth had been produced and it is possible that more teeth may develop in the future.     

Supernumerary teeth: a case report

Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral erupted or unerupted and in one or both jaws. Multiple supernumerary teeth are rare in individuals with no other associated diseases or syndromes. Our case presents with 12 supernumerary teeth in permanent dentition, of which six were erupted and six unerupted and a history of extraction of three teeth with no associated syndrome.     

Study of the frequency and the features of supranumerary teeth found in one Portuguese population

The present study was performed on a population of subjects assisted at the dental clinic of Instituto Superior de Ciências da Saúde-Norte. The aims of the study were: (1) to analyse the prevalence of supernumerary teeth, (2) to characterise its gender distribution, and (3) to investigate the repercussions of supernumerary teeth over neighbouring teeth and tissues. From the records of all the patients received from 1993 to 2000, 16771 clinical files contained panoramic X-ray plates (8712 females and 8059 males) and were selected. A total of 151 supernumerary teeth were found in 127 patients (72 males and 55 females, aged from 5 to 63 years), corresponding to a prevalence of 0.76%. Other designed important issues were one supernumerary teeth for individual; the mesiodens type (followed by the 4th molar); conical morphology; the maxilla (namely on the maxillary medial line): location as predominant findings. Evolutionary state, 47 (31.1%) were erupted and 104 (68.9%) unerupted. In most cases 108 (71.5%), the radiological images didn't suggest alterations on adjacent teeth and/or tissues. The repercussions found, potentially associated to supernumerary teeth were: 12 (7.9%) displacement of adjacent teeth, nine (6%) delayed eruption of permanent teeth, and eight cases (5.3%) diastema formation.     

Fourth molars in the maxilla and mandible--a rare phenomenon

The occurrence of supernumerary teeth is not uncommon. The preferred location of the supernumerary teeth is in the maxilla, mostly incisors, followed by the molars. Supernumerary molars are divided into two types, depending on their location: distomolars and paramolars. Distomolars are supernumerary teeth that are distal to the third molars, while paramolars are supernumerary teeth on the side of the molars. The paper describes an unusual case of four distomolars. The two maxillary distomolars were unerupted, in a vertical position distal to the third molars. Their morphology was normal but they were smaller than the regular molars. The two mandibular distomolars were unerupted, in a horizontal position distal to the third molars. Their morphology was normal but they were smaller than the regular molars. Cases of four distomolars with normal morphology are extremely rare and have seldom been reported in the dental literature. The phenomenon is interesting especially considering the fact that in modern man, missing third molars are becoming a common finding.     

Differential expressions of bilaterally unerupted supernumerary teeth

This article presents a case of bilateral unerupted supernumerary teeth in the mandibular premolar region. Surgical removal of the right-sided supernumerary tooth had to be carried out as it was impeding the eruption of the mandibular first premolar. However, its supernumerary antimere, lay dormant.     

Multidisciplinary evaluation and clinical management of mesiodens

Supernumerary teeth are a disorder of odontogenesis relatively common in the oral cavity and characterized by an excess number of teeth. The term mesiodens is used to refer to an unerupted supernumerary tooth in the central region of the premaxilla between the two central incisors. The complications associated with mesiodens include: lack of eruption of permanent teeth, the deviation of the eruption path, rotations, retention, root re-absorption and pulp necrosis with loss of vitality, and diastema. Early detection of mesiodens is most important if such complications are to be avoided. This report describes the treatment of a maxillary central incisor impacted by a mesiodens. The case initially required only surgical treatment, to remove the supernumerary tooth. Successively, orthodontic therapy was done to bring into position the left permanent central incisor, which erupted physiologically, but rotated 90 degrees around along its long axis.     

Prevalence and characteristics of intracoronal resorption in unerupted teeth in the permanent dentition: a retrospective study

Objective  To determine the prevalence, types of teeth, and distribution of intracoronal resorption in permanent dentition in a large population. Methods  A total of 9,570 panoramic radiographs were screened, and 2,922 unerupted teeth were examined. Results  The prevalence of intracoronal dentine defects was 1.55% in subjects and 0.95% in teeth. The highest prevalence of intracoronal radiolucencies was noted in the mandibular second molar (9.5%), followed by the maxillary second premolar tooth (4.7%). To our knowledge, this is the first report of coronal radiolucency in maxillary supernumerary teeth. Of the lesions identified, 39.3% were two-thirds of the dentine thickness, and 21.4% included the enamel; 85.7% of the defects were located at the central aspect of the crown. Ectopically positioned teeth showing intracoronal resorption accounted for 14.3% of the cases. Conclusions  Intracoronal resorption in an unerupted tooth occurs frequently and can be seen in more than one tooth in an individual. This condition is usually associated with not only an ectopic position but also resorption, which may be a progressive process. Dental clinicians should conduct periodic follow-ups, both clinical and radiographic, of these unerupted teeth.