Lucey S, Heath N, Welbury R R, Wright G
Dept. Paediatric Dentistry, University of Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow, Scotland.
Eur Arch Paediatr Dent. 2009 Nov;10 Suppl 1:49-53. doi: 10.1007/BF03262702.
The diagnosis and management strategies of double teeth have largely relied on clinical examination and conventional radiographic findings. Cone-Beam Computed Tomography (Cone-beam CT) was developed in the late 1990's and, therefore, is a relatively recent addition to the imaging armamentarium for use in Maxillofacial Radiology. There have been no publications in the dental literature demonstrating the use of Cone-beam CT or 3D stereolithography in the diagnosis and surgical planning of the management of double teeth.
An 11 year old girl presented with a double left lateral maxillary incisor. Conventional plain film radiography failed to provide the requisite information for pre-operative planning. Cone-beam Computed Tomography (Cone-beam CT) allowed determination of location of fusion, three-dimensional (3D) visualisation of pulpal anatomy and the construction of a 3D stereolithographic model for surgical planning. The double tooth was surgically divided in situ under local analgesia. The redundant distal unit was extracted and the residual mesial unit built up in composite resin following physiological mesial drift of displaced maxillary left canine. No endodontic therapy was required.
FOLLOW-UP: At a 10-month follow-up visit, clinical and radiographic vitality and success was noted.
The great amount of radiological information which Cone-beam CT can offer not only improves pre-operative and surgical planning, but the 3D models provided can be used to further educate and inform patients and guardians in the management of double teeth.
双牙的诊断和治疗策略很大程度上依赖于临床检查和传统影像学检查结果。锥形束计算机断层扫描（CBCT）于20世纪90年代末开发，因此是颌面放射学影像设备中相对较新的一种。牙科文献中尚无关于使用CBCT或3D立体光刻技术进行双牙诊断和手术规划的报道。
一名11岁女孩出现左侧上颌侧切牙双牙畸形。传统平片放射摄影未能提供术前规划所需的信息。锥形束计算机断层扫描（CBCT）能够确定融合位置，三维（3D）显示牙髓解剖结构，并构建3D立体光刻模型用于手术规划。在局部麻醉下对双牙进行原位手术分离。拔除多余的远中牙体单位，待上颌左侧移位尖牙生理性近中漂移后，用复合树脂修复剩余的近中牙体单位。无需进行牙髓治疗。
在10个月的随访中，观察到临床和影像学检查显示牙齿活力正常且治疗成功。
锥形束计算机断层扫描（CBCT）能够提供大量放射学信息，不仅改善了术前和手术规划，而且所提供的3D模型可用于在双牙治疗中进一步教育患者及其监护人并为他们提供信息。
