上顎異位萌發第一大臼齒使用改良式Halterman裝置扶正：兩例病例報告

Ectopic Eruption of Upper First Permanent Molar and Uprighted with Modified Halterman Appliance : Two Cases Report

陳永盼(Yung-Pan Chen) ； 謝春怡(Chun-Yi Hsieh) ； 施文宇(Wen-Yu Shih)

《臺灣兒童牙醫學雜誌》 18卷3期 (2018/09) Pp. 103-110

https://doi.org/10.6319/TJPD.201809_18(3).0004

摘要

異位萌發係指恆牙在萌發時並未按照正常萌發路徑而造成鄰近牙牙根不正常吸收的情況，而以上顎第一大臼齒為最常見的異位萌發牙位。有部分第一大臼齒會自行循正確路徑萌發出來，而另一部份若未經過早期適當治療通常會造成第二乳臼齒早期喪失，而導致空間喪失，並衍生出咬合不正的問題。有多位學者建議早期治療，藉由施予第一大臼齒往遠心的力量而改正萌發路徑。其中Halterman裝置最常被使用，但若作為支台齒的第二乳臼齒有嚴重牙根吸收及搖動度時，本裝置無法使用或效果不佳，經改良過的Halterman裝置有增加上顎顎側空間維持器構件來增強錨定，並改以附近第一乳臼齒作為支台齒。本報告包含使用改良式Halterman裝置，皆使異位萌發的第一大臼齒回到正常萌發路徑。

關鍵字

異位萌發 ； 上顎第一大臼齒 ； 改良式Halterman裝置

並列摘要

Ectopic eruption was defined as a condition in which the permanent teeth assume a path of eruption that intercepts a primary tooth, some may irreversibly causes its root resorption and premature loss, producing a consequent space loss and malocclusion. Moreover, the most commonly affected tooth is the maxillary first molar. Many reports suggest to have early intervention by giving a force to correct the permanent molar's position to more distally to its normal position. One of the appliance which is introduced by Halterman is commonly used. However the mesial second primary molar which is used as abutment tooth may be difficult to work as abutment due to the severe resorption of distal root and great mobility. The modified Halterman appliance added Nance component to reinforce abutment and change the abutment tooth to mesial primary first molar. The two cases report was presented by using modified Halterman appliance with satisfying result.

並列關鍵字

ectopic eruption ； maxillary first permanent molar ； modified Halterman appliance