Russell Kathleen A, Folwarczna Magdalena A
Division of Orthodontics, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada.
J Can Dent Assoc. 2003 Jun;69(6):362-6.
Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Given this high frequency, the general dentist should be knowledgeable about the signs and symptoms of mesiodentes and appropriate treatment. The cause of mesiodentes is not fully understood, although proliferation of the dental lamina and genetic factors have been implicated. Mesiodentes can cause delayed or ectopic eruption of the permanent incisors, which can further alter occlusion and appearance. It is therefore important for the clinician to diagnose a mesiodens early in development to allow for optimal yet minimal treatment. Treatment options may include surgical extraction of the mesiodens. If the permanent teeth do not erupt in a reasonable period after the extraction, surgical exposure and orthodontic treatment may be required to ensure eruption and proper alignment of the teeth. In some instances, fixed orthodontic therapy is also required to create sufficient arch space before eruption and alignment of the incisor(s). Early diagnosis allows the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications. This paper outlines the causes and modes of presentation of mesiodentes, and presents guidelines for diagnosis and management of nonsyndromic mesiodentes.
正中多生牙是最常见的额外牙，在人群中的发生率为0.15%至1.9%。鉴于其高发生率，普通牙医应了解正中多生牙的体征和症状以及适当的治疗方法。尽管牙板增殖和遗传因素被认为与正中多生牙的发生有关，但其病因尚未完全明确。正中多生牙可导致恒牙延迟萌出或异位萌出，进而进一步改变咬合和外观。因此，临床医生在其发育早期诊断出正中多生牙很重要，以便进行最佳且微创的治疗。治疗选择可能包括手术拔除正中多生牙。如果拔除后恒牙在合理时间内未萌出，可能需要进行手术暴露和正畸治疗，以确保牙齿萌出和正确排列。在某些情况下，还需要进行固定正畸治疗，以便在切牙萌出和排列前创造足够的牙弓间隙。早期诊断可实现最恰当的治疗，通常可减少手术范围、正畸治疗及可能的并发症。本文概述了正中多生牙的病因和表现方式，并提出了非综合征性正中多生牙的诊断和管理指南。
