Management of Space Loss Caused by Severely Ankylosed Primary Molar: A Clinical Case Report

嚴重乳臼齒骨沾黏造成空間喪失之處理－病例報告

黃慈睿(Tzu-Jui Huang) ； 徐儷芳(Li-Fang Hsu)

《中華民國家庭牙醫學雜誌》 15卷1期 (2020/06) Pp. 30-35

https://doi.org/10.6566/JFD.202006_15(1).0006

摘要

When managing ankylosed teeth, early recognition, comprehensive treatment planning, and routine recall visits are all crucial parts to a successful treatment. If infraoccluded teeth due to ankylosis left untreated, many complications of occlusal development may occur. Treatment options including periodic monitoring, restoration, luxation and surgical extraction are reported. This case report presents a 10-year-old boy with severely ankylosed mandibular second primary molar and an altered path of eruption of the successor tooth germ. Space problems and occlusal discrepancies such as tipping of mandibular left first permanent molar, extrusion of antagonist teeth and lower anterior teeth spacing were noted. Surgical extraction of the ankylosed primary molar and orthodontic intervention were performed for this case. After four months of orthodontic active treatment, we achieved sufficient space for the permanent successor to erupt. After three years of periodic follow-ups, spontaneous eruption of the mandibular left second premolar was noted clinically and radiographically.

關鍵字

primary molars ankylosis ； infraocclusion ； space regain

並列摘要

在處理骨沾黏的乳臼齒時，早期發現，全面性的治療計畫及定期的回診追蹤對於一個成功的治療都是不可或缺的。骨沾黏的牙齒咬合面會低於其他牙齒，如果沒有即時的介入處理會產生很多咬合上的問題。對於骨沾黏的乳臼齒，治療方式有很多種，包括持續的追蹤觀察，以復形的方式恢復咬合高度及空間，使其脫位，拔除乳臼齒等等。本病歷報告呈現的是一位十歲男童，確診為左下第二乳臼齒嚴重型骨沾黏伴隨第二小臼齒牙胚位移。同時有許多空間及咬合上面的問題，例如左下第一大臼齒往骨沾黏的乳牙方向傾倒，咬合對側的牙齒過度萌出及下顎前牙間隔過大。治療方式選擇手術拔除骨沾黏的乳臼齒並進行四個月的矯正治療後，繼生齒已有足夠的萌發空間。在經過三年的定期追蹤後，從臨床及放射線下可見到骨沾黏乳牙下的第二小臼齒已順利萌出。

並列關鍵字

乳臼齒骨沾黏 ； 牙齒低萌發位 ； 空間再生