Ashkenazi Malka, Greenberg Beatrice P, Chodik Gabriel, Rakocz Meir
Department of Pediatric Dentistry, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Orthod Dentofacial Orthop. 2007 May;131(5):614-9. doi: 10.1016/j.ajodo.2005.09.032.
Impacted teeth do not always erupt spontaneously after removal of supernumerary teeth or odontomas. The purpose of this study was to examine the effect of several variables on eruption of impacted teeth in children with supernumeraries or odontomas.
The sample consisted of 53 patients with 69 impacted teeth; the supernumeraries or odontomas were removed without other interventions. The patients were identified retrospectively and followed until the impacted teeth erupted to their correct positions or until orthodontic traction was started.
Loss of space, a second surgical procedure, a third surgical procedure, and orthodontic treatment were recorded in 77.6%, 53.8%, 9.4%, and 85% of the patients, respectively. Spontaneous eruption occurred in 83%, 75%, 46%, 19%, and 32% of the impacted teeth with normal and small size superlative, conical, tuberculated, and odontoma forms, respectively. In the univariate analysis, spontaneous eruption correlated with apex distance of the impacted tooth relative to its estimated position (P <.001), extent of vertical impaction (P <.001), obstacle form (P <.019), stage of root development of supernumerary tooth (P = .006), angle of impaction relative to the midline (P = .015), and time of surgery (P = .05). In the multivariate logistic regression analysis, higher distraction of the apex of the impacted tooth relative to its estimated correct position and the obstacle form (tuberculated and odontomas) were independently associated with impediment of spontaneous eruption (P = .03 and P = .04, respectively).
Spontaneous eruption of impacted teeth correlated mostly with lower distraction of the impacted tooth apex and obstacle form (conical and superlative). Immediate orthodontic traction is recommended concomitantly with the first surgery to remove supernumerary teeth.
多生牙或牙瘤拔除后，阻生牙并非总能自行萌出。本研究旨在探讨多个变量对患有多生牙或牙瘤儿童阻生牙萌出的影响。
样本包括53例患者的69颗阻生牙；多生牙或牙瘤在未进行其他干预的情况下被拔除。对患者进行回顾性识别并随访，直至阻生牙萌出至正确位置或开始正畸牵引。
分别有77.6%、53.8%、9.4%和85%的患者记录了间隙丧失、第二次手术、第三次手术和正畸治疗情况。正常形态、小尺寸、锥形、结节状和牙瘤状的阻生牙中，分别有83%、75%、46%、19%和32%实现了自行萌出。在单因素分析中，自行萌出与阻生牙相对于其估计位置的根尖距离（P <.001）、垂直阻生程度（P <.001）、阻碍形态（P <.019）、多生牙的牙根发育阶段（P =.006）、相对于中线的阻生角度（P =.015）以及手术时间（P =.05）相关。在多因素逻辑回归分析中，阻生牙根尖相对于其估计正确位置的更大移位以及阻碍形态（结节状和牙瘤状）与自行萌出受阻独立相关（分别为P =.03和P =.04）。
阻生牙的自行萌出主要与阻生牙根尖较小移位和阻碍形态（锥形和正常形态）相关。建议在首次拔除多生牙手术的同时立即进行正畸牵引。
