治療單側多發性恆牙埋伏齒－病例報告

依照人類換牙時序，大約十二歲可將第二大臼齒之前的牙齒萌發完成。換牙通常是左右對稱性萌發，若一邊的牙齒已經冒出來了，而另一邊卻遲遲沒有動靜，超過三個月以上未萌發，即建議接受牙醫師的檢查。本病例報告為一14 歲男性，因下顎右側乳牙脫落後，第二小臼齒、第一大臼齒、第二大臼齒等恆牙卻遲遲未見萌發，而下顎左側對應恆牙均已萌出，因此由母親陪同至本院牙科求診。早先曾在診所照過根尖x光片，確認齒槽骨內有牙，診所醫師曾將牙齦切開，但牙齒還是沒有長出來。患者使用手術露出牙冠合併矯正牽引方式治療，歷時2年7個月。術後環口x光檢查治療成效：右側下顎第二小臼齒、第一大臼齒、第二大臼齒均已萌出有咬合功能，齒槽骨高度良好，且第二小臼齒與第二大臼齒牙根尖也已完全成形，根尖癒合，牙髓測試呈現陽性反應。美中不足為牽引過程中，右側下顎第二小臼齒、第一大臼齒、第二大臼齒扶正後產生小牙縫，使用彈性橡皮圈前後對拉關閉空間時，造成了下顎前牙中線偏右。此外，患者之口腔衛生不良，戴上矯正器後又使牙齒清潔不易，因此產生許多蛀牙有待治療填補。此外，第二小臼齒牙根與第一小臼齒相比似乎短了一點，第二大臼齒與第一大臼齒牙根相比似乎也短了一點，將來應該長期追蹤牙根是否仍有繼續生長，也要觀察後續牙髓腔是否有阻塞的情形發生。

關鍵字

單側；多發性；恆牙埋伏齒

並列摘要

According to the normal sequence of permanent teeth eruption, the 2^(nd) molars germinate around the age of twelve. Usually, permanent teeth erupt symmetrically. A dental examination is recommended if one side of the teeth erupt while the other remain silent for more than three months. This case report is about a 14-year-old young male with missing 2^(nd) premolar, 1^(st) and 2^(nd) molars on his right lower arch after deciduous teeth exfoliation, while his 2^(nd) premolar, 1^(st) and 2^(nd) molars were all existed on the left side. His mother brought him to us for dental consultation. Earlier periapical X-ray film taken in a local dental clinic showed existence of the teeth. A gingival incision was performed by the clinic dentist but still, the teeth did not erupt. We treated the patient with surgical crown exposure and followed by traction with orthodontic device. The treatment time expended 2 years and 7 months. Postoperative panoramic X-ray examination showed that the 2^(nd) premolar, 1^(st) and 2^(nd) molars were all coming into the arch with a favorable alveolar bone height. All traction teeth fully erupted and each of their root apex performance was satisfying. EPT tests revealed positive responses. However, the lower midline was off to right due to closing multiple spaces produced when up-righting the embed teeth with elastic power chain. In addition, the patient's oral hygiene was poor and the appliance made teeth clean more difficult, yielding caries to be filled afterward. Furthermore, the root length of the 2^(nd) premolar seemed shorter than that of the 1^(st) premolar. Also, the root length of the right 1^(st) and 2^(nd) molars were shorter than that of those on the left side. Long term follow-up to monitor continuous growth of the root and obstruction of the pulp chamber should be carried out.

並列關鍵字

unilateral ； multiple permanent embedded teeth

國際替代計量

治療單側多發性恆牙埋伏齒－病例報告

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