Shih Wen-Yu, Hsieh Chun-Yi, Tsai Tzong-Ping
Division of Pedodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Faculty of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.
Division of Pedodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2016 Jun;79(6):345-50. doi: 10.1016/j.jcma.2015.10.013. Epub 2016 Apr 15.
Mesiodens is a common clinical finding among children and has a higher prevalence in Asian populations. The timing of the removal of mesiodens remains controversial. Clinical studies comparing early versus late removal are lacking. The aim of this retrospective study was to evaluate the frequency of clinical complications regarding the timing of childhood mesiodens removal and to explore the factors associated with complications following mesiodens removal.
In total, 384 Taiwanese children diagnosed with unerupted mesiodens who had attended the Pediatric Dentistry Department, Taipei Veteran General Hospital, Taipei, Taiwan from 2005 to 2012 were identified as potential participants. Among these patients, 105 children had received surgical odontectomy of the mesiodens under general anesthesia and had complete longitudinal clinical and radiographic follow-up records, including computed tomography (CT) evaluations; these patients were enrolled. The influence of age, the developmental stage of the adjacent permanent teeth, and the location of the mesiodens were explored regarding complications that were noted at the time of surgery, injury to the adjacent permanent teeth during surgical intervention, and the need for orthodontic treatment after surgery.
The 105 children enrolled had 145 mesiodens. Removal of the mesiodens before the child was 5 years of age or 1/3 root-completed was associated with fewer complications at the time of surgery and a reduced need for orthodontic treatment after surgery. However, no significant difference was noted between the different groups in terms of surgical injury to the adjacent permanent teeth.
The early removal of an unerupted mesiodens before the age of 5 years would seem to reduce complications and the need for orthodontic treatment. With the help of general anesthesia and evaluation by CT imaging, concerns regarding the child's cooperation and the possibility of damage to adjacent permanent teeth during early surgical intervention can be minimized.
正中多生牙是儿童常见的临床发现，在亚洲人群中患病率较高。正中多生牙的拔除时机仍存在争议。缺乏比较早期拔除与晚期拔除的临床研究。本回顾性研究的目的是评估儿童正中多生牙拔除时机的临床并发症发生率，并探讨与正中多生牙拔除后并发症相关的因素。
共确定了384名被诊断为埋伏正中多生牙的台湾儿童，他们于2005年至2012年在台湾台北荣民总医院儿童牙科就诊，作为潜在参与者。在这些患者中，105名儿童在全身麻醉下接受了正中多生牙的外科拔牙术，并拥有完整的纵向临床和影像学随访记录，包括计算机断层扫描（CT）评估；这些患者被纳入研究。探讨了年龄、相邻恒牙的发育阶段以及正中多生牙的位置对手术时出现的并发症、手术干预期间对相邻恒牙的损伤以及术后正畸治疗需求的影响。
纳入的105名儿童共有145颗正中多生牙。在儿童5岁之前或牙根完成1/3之前拔除正中多生牙，手术时并发症较少，术后正畸治疗需求降低。然而，不同组在对相邻恒牙的手术损伤方面没有显著差异。
在5岁之前早期拔除埋伏正中多生牙似乎可以减少并发症和正畸治疗需求。借助全身麻醉和CT成像评估，可以将对儿童配合度的担忧以及早期手术干预期间对相邻恒牙造成损伤的可能性降至最低。
