- 期刊
The Clinical Management of Unerupted Premolars
未萌發小臼齒的臨床處理
摘要
在齒列發育過程中，小臼齒往往具有高度的變異性，而使得臨床上常可發現病患因小臼齒異位阻生或先天缺失等情形，尋求進一步的矯正分析與治療。 在診斷未萌發小臼齒時，首先要由X先片中觀察小臼齒是否先天缺失，亦或是異位阻生而導致沒有萌發。並且評估小臼齒在齒槽骨中的位置與萌發方向，發育階段，及是否有局部干擾因素造成牙齒萌發過程受阻等。而在治療計畫的擬定上，則首重釐清小臼齒在患者的齒列中所扮演的角色，並考量患者年紀與齒列發育，咬合不正的種類，空間分佈的情形與顏面外觀等因素，訂定出理想的治療方式。 本次報告將針對文獻中有關未萌發小臼齒的可能發生原因，臨床診斷需要考慮的因素，以及治療計畫的訂定等作詳細的探討，以提供臨床醫師日後處理相關問題的參考。
並列摘要
The human premolars are highly variable in development with considerable high incidence of tooth impaction and agenesis. Therefore the unerupted and impacted premolars are common problems in daily clinical practice and the reason for many orthodontic and pediatric dental referrals. Failures to detect and analyze the anomaly and mismanagement of this problems may result in space loss, teeth malposition, collapse of the dental arch, periodontal damage, and significant oral functional consequences. Radiographic assessment and clinical examination are important in diagnosis of the unerupted premolar with respect to its presence in the jaw, its position and orientation, the stage of its development, and local mechanical interfering factors. Treatment considerations of this problem should first determine what role this condition can best play in the overall treatment of the malocclusion. With regard to the patient's age, the dental development, the type of malocclusion, space distribution, and facial esthetics, then the individualized treatment plan can be made appropriately. In cases where premolars are unerupted or impacted, a multidisciplinary approach is indicated involving pedodontics, orthodontics, oral surgery as well as prosthodontics to establish the optimal treatment plan.