Management of Bilateral Ectopically-erupted Maxillary First Permanent Molars : A Case Report

Ectopic eruption is reported with prevalence of 3% to 4% and mostly affecting maxillary first permanent molars. The clinical classification includes two types: The jump type, which means the eruption path becomes normal, and the locked type, indicating that the eruption path remains mesially obstructed. Although most of the ectopic eruption is reversible, the challenge for the dental practitioners is to provide timely intervention when the affected tooth fails to self-correct. Leaving ectopic eruption untreated will lead to distal root resorption and even early exfoliation of primary second molars, and thus inevitable loss of the arch perimeter will occur. A 6-year-old boy came to our OPD with clinical signs of shedding maxillary primary second molars and ectopic eruption of maxillary permanent first molars on both sides. Radiographic examinations revealed bilateral ectopic erupted permanent first molars suspect of locked type. After observation, spontaneously exfoliation of bilateral maxillary primary second molars occurred, and the space loss reached 5mm on each side. Molar distalization was conducted and the space between primary second molars and first permanent molars was created. The space maintaining device was given to retain the space for future eruption of permanent second premolars. Serial recall visits were documented, and further management will be initiated in later stage.

關鍵字

Ectopic eruption ； Molar distalization ； Space maintainers ； Agenesis of tooth

並列摘要

恆牙第一大臼齒異位性萌發為牙科早期混合齒列常見之症狀。其發生率為3～4％，臨床區分為自動緩解型以及阻生型兩種狀況。雖然大多數屬於自動緩解型，但是阻生型會造成乳牙提早脫落、合併牙弓空間喪失，及將來恆牙發育困難。本案例為一名六歲男童患有雙側阻生型恆牙大臼齒異位性萌發，導致乳牙提早脫落，並同時患有右上第二大臼齒牙胚缺失。經過雙側恆臼齒遠移術之治療，重獲牙弓空間，並給予上顎雙側空間維持器進行空間保持。定時追蹤臨床狀況後，因為上顎發育有限，待其進入中期混合齒列時期將需要進一步的矯正。此案例顯示，異位性萌發可能合併先天的上顎發育不足及連帶牙胚缺失，需要逐步進行矯正治療，牙弓空間的維持及觀察也更顯重要。

並列關鍵字

異位性萌發；臼齒遠移術；空間維持器；牙胚缺失

國際替代計量

Management of Bilateral Ectopically-erupted Maxillary First Permanent Molars : A Case Report

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