尚未萌發的上顎正中恆門牙冠斷裂－病例報告

Crown Fracture of an Unerupted Permanent Maxillary Central Incisor - A Case Report

葉倩穎(Chien-Ying Yeh) ； 蕭思郁(Szu-Yu Hsiao)

《臺灣兒童牙醫學雜誌》 18卷4期 (2018/12) Pp. 150-157

https://doi.org/10.6319/TJPD.201812_18(4).0004

摘要

背景：乳牙齒列外傷相當常見，大約每20名就有1名兒童有乳牙齒列外傷的經驗。由於乳牙的根尖與其繼生齒牙胚的位置相當密切，乳牙齒列外傷可能導致恆牙的發育障礙，Andreasen等人將恆牙因乳牙時期外傷導致的常見發育障礙分成十類。然而，此分類沒有提到物體直接碰撞發育中的恆牙可能造成的損傷（如牙冠斷裂）。病例報告：本病例是一位6歲7個月的男孩，因為跌倒導致尚未萌發的左上正中恆門齒牙冠斷裂。藉由錐狀射束電腦斷層掃描（CBCT）搭配傳統X光片檢查發現左上正中恆門齒牙冠斷裂的情況。於萌發前以BiodentineTM施行活髓治療（Vital Pulp Therapy），後續以矯正治療及牙齒斷片復形來重建其美觀及功能。討論與結論：尚未萌發的恆門齒牙冠斷裂的病例相當罕見。本病例利用活髓治療、矯正治療最後將牙齒斷片接回原位，來達到較好的治療結果。

關鍵字

牙冠斷裂 ； 未萌發恆門齒 ； 活髓治療

並列摘要

Background: Developmental disturbances to the permanent teeth can be caused by trauma to the primary dentition, because the close relationship between the primary teeth and the developing permanent successors. Andreasen has classified such disturbances that can occur to developing permanent teeth into ten different categories. However, this classification does not include injuries that may occur by direct contact of the impacting object with a developing tooth, such as a crown fracture. Case reports: This report presents a case of a 6-year-7-month boy who suffered from crown fracture of the unerupted upper left permanent central incisor. We detected the fractured permanent central incisor and defined the fracture line by CBCT and conventional dental radiography. The fractured permanent central incisor was treated with vital pulp procedures using Biodentine TM before the tooth eruption. Then, orthodontic treatment and reattachment of the fractured segment were preformed for esthetics and function. Discussion and conclusion: A case of crown fracture of an unerupted permanent incisor is definitely rare. We used vital pulp therapy, orthodontic treatment and reattachment of the fractured segment to achieve a favorable outcome.

並列關鍵字

Crown Fracture ； Unerupted Permanent Incisor ； Vital Pulp Therapy