Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul University, Capa/Fatih, 34093, Istanbul, Turkey.
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.
Oral Radiol. 2021 Jul;37(3):403-411. doi: 10.1007/s11282-020-00464-9. Epub 2020 Jul 6.
The purpose of this study is to evaluate CBCT images of impacted mandibular canines in detail and to discuss implications for diagnosis and treatment.
CBCT images of dental patients applied between December 2015 and December 2017 were evaluated retrospectively. 2591 CBCT images, including mandible in their field of view, were determined and evaluated regarding the presence of mandibular canine impaction. 66 impacted mandibular canines of 58 patients were analyzed in detail regarding their location, morphology, associated pathologies, and their relationship with the neighboring anatomic structures, the role of these factors on transmigration, as well as treatments applied. The Pearson Chi square test was used between the groups.
Transmigration was observed in 53% of impacted mandibular canines. Teeth with transmigration were localized horizontally, below the apex of adjacent teeth frequently, and had no contact with mandibular cortical bone mostly. 62% of mandibular canines were in contact/proximity with the incisive mandibular canal. The most applied treatment for transmigrated teeth was surgical removal, followed by radiographic monitoring, but orthodontic traction was not preferred in any case. For non-transmigrated teeth, the most applied treatment options were surgical removal, orthodontic traction, and radiographic monitoring, respectively. Autotransplantation was not preferred in any case of impacted teeth. Vertical position of the crown tip (p < 0.05) and the presence of deciduous mandibular canines and their resorption showed significant relation to transmigration (p < 0.05).
Transmigration is common among impacted mandibular canines. Resorption of adjacent teeth roots was one of the possible complications of impaction and likely contact/proximity of incisive mandibular canal with impacted mandibular canines, which may pose difficulties in surgical treatment, can be better detected by CBCT.
本研究旨在详细评估下颌阻生尖牙的 CBCT 图像，并讨论其对诊断和治疗的影响。
回顾性评估了 2015 年 12 月至 2017 年 12 月期间就诊的牙科患者的 CBCT 图像。确定并评估了 2591 张包括下颌骨在内的 CBCT 图像，以评估下颌尖牙阻生的存在情况。对 58 例患者的 66 颗下颌阻生尖牙的位置、形态、相关病变及其与邻近解剖结构的关系、这些因素对迁移的作用以及应用的治疗方法进行了详细分析。对各组间采用 Pearson 卡方检验。
53%的下颌阻生尖牙发生了迁移。发生迁移的牙齿多位于水平位置，常低于相邻牙齿的根尖，且大多与下颌皮质骨无接触。62%的下颌尖牙与下颌切牙管接触/接近。对于迁移牙，最常应用的治疗方法是手术切除，其次是放射监测，但在任何情况下都不推荐正畸牵引。对于未迁移的牙齿，最常应用的治疗选择分别为手术切除、正畸牵引和放射监测。在任何情况下都不推荐进行自体移植。牙冠尖端的垂直位置（p<0.05）和乳牙下颌尖牙及其吸收的存在与迁移有显著关系（p<0.05）。
下颌阻生尖牙中常见迁移现象。相邻牙齿牙根的吸收是阻生的可能并发症之一，而与下颌阻生尖牙接触/接近的下颌切牙管可能会增加手术治疗的难度，通过 CBCT 可以更好地检测到这种情况。
