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阻生尖牙导致上颌侧切牙根吸收:一项文献综述。

Root resorption of the maxillary lateral incisor caused by impacted canine: a literature review.

作者信息

Alqerban A, Jacobs R, Lambrechts P, Loozen G, Willems G

机构信息

Department of Orthodontics, Faculty of Medicine, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.

出版信息

Clin Oral Investig. 2009 Sep;13(3):247-55. doi: 10.1007/s00784-009-0262-8. Epub 2009 Mar 11.

Abstract

Root resorption of maxillary lateral incisors caused by erupting canines is well known and a relatively common phenomenon. However, much debate and conflicting evidence exists with regard to the actual resorption trigger and potential etiological factors involved. Consequently, there are no obvious clinical clues concerning prevention and diagnosis as well as subsequent treatment decisions. The introduction of cone beam computer tomography has recently allowed drawing a new and much more documented light on the diagnostic and therapeutic strategies. However, no investigations have determined that this new information may result in another and better diagnostic approach and an improved treatment outcome. Therefore, the present review will attempt to summarize the existing evidence on two- and three-dimensional images and try to link the radiological observations to any further preventive, diagnostic, and/or therapeutic measures. Detection thresholds, accuracy, and reliability of impacted canine localization and neighboring root resorption risks will also be considered. This review demonstrates how adding a third-dimension to the radiographic information may notably alter the prevalence of root resorptions and descriptions of this prevalence. In any case, further investigation is needed to determine resorption detection thresholds in various two-dimensional and three-dimensional imaging techniques, as well as to determine therapeutic thresholds and criteria for strategic tooth extraction based on radiographic manifest and not manageable resorption lesions.

摘要

上颌尖牙萌出导致上颌侧切牙根吸收是众所周知且相对常见的现象。然而,关于实际的吸收触发因素及潜在病因,存在诸多争议和相互矛盾的证据。因此,在预防、诊断以及后续治疗决策方面,没有明显的临床线索。锥形束计算机断层扫描技术的引入,最近为诊断和治疗策略带来了新的、记录更为详尽的思路。然而,尚无研究确定这些新信息是否会带来另一种更好的诊断方法及改善的治疗效果。所以,本综述将尝试总结二维和三维图像方面的现有证据,并试图将放射学观察结果与任何进一步的预防、诊断和/或治疗措施联系起来。还将考虑埋伏尖牙定位的检测阈值、准确性和可靠性以及相邻牙根吸收风险。本综述表明,在放射影像信息中增加三维维度可能会显著改变根吸收的发生率及其描述。无论如何,需要进一步研究以确定各种二维和三维成像技术中的吸收检测阈值,以及基于放射影像表现和不可处理的吸收病变确定治疗阈值和策略性拔牙标准。

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