Jenkins F R, Nichol R E
Dept Paediatric Dentistry, Leeds Dental Institute, Leeds, England.
Eur Arch Paediatr Dent. 2008 Mar;9(1):51-5. doi: 10.1007/BF03321597.
Infraocclusion of primary molar teeth is relatively common. The majority of infraoccluded primary molars with permanent successors exfoliate naturally. There are currently no evidence based guidelines for the treatment of infraoccluded primary molars with permanent successor teeth.
The three cases presented demonstrate atypical retention of infraoccluded primary molars, following a conservative approach. In case 1 taking a conservative approach over 5 years, the infraocclusion became gradually more severe. Tilting of the adjacent teeth and the centre-line shift caused by leaving the affected tooth in place during dental and alveolar development was significant. In Case 2 the severely infraoccluded 55 required surgical removal and exposure of the underlying permanent successor (15). Case 3 showed a maxillary premolar (14) and first permanent molar (16) tilted toward the partially erupted, ectopic, rotated 15. Surgical removal of the impacted maxillary primary molar was required.
Although there is evidence available to support the conservative treatment of such cases, it does not always lead to a favourable outcome. Detrimental effects on the adjacent teeth and occlusion were observed and surgical intervention was required.
乳牙下沉相对常见。大多数有恒牙胚的下沉乳牙会自然脱落。目前尚无基于证据的关于治疗有恒牙胚的下沉乳牙的指南。
所呈现的三个病例展示了在采取保守治疗方法后，下沉乳牙出现非典型滞留的情况。病例1采取保守治疗方法超过5年，下沉情况逐渐加重。在牙齿和牙槽发育过程中，保留患牙导致相邻牙齿倾斜和中线偏移明显。病例2中，严重下沉的55号牙需要手术拔除并暴露其下方的恒牙胚（15号牙）。病例3显示上颌前磨牙（14号牙）和第一恒磨牙（16号牙）向部分萌出、异位、旋转的15号牙倾斜。需要手术拔除阻生的上颌乳牙。
尽管有证据支持对此类病例进行保守治疗，但并非总能取得良好效果。观察到对相邻牙齿和咬合有不良影响，需要进行手术干预。
