State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
Am J Orthod Dentofacial Orthop. 2021 Feb;159(2):e169-e177. doi: 10.1016/j.ajodo.2020.09.020.
The present study aimed to analyze possible factors involved in irreversible (IRR) ectopic eruption (EE) of the first permanent molar and explore potential predictors for the IRR outcome.
Children aged 4-11 years, with at least 1 EE and who took their first panoramic radiograph before the age of 8 years, were selected in this study. The subjects were assigned to the self-correcting (SC) and IRR groups. Patients' age, sex, distribution of EE, and accompanying dental anomalies were recorded. Eruptive angulation (EA) of the first permanent molar, the grade of root resorption in the second deciduous molar, the magnitude of impaction index (MOII), and horizontal distance were measured on the panoramic radiographs. Chi-square tests and independent-sample t test were used for nominal and continuous variables, respectively. The receiver operative characteristic curve was used to determine the critical value.
A total of 406 children with 634 first permanent molars, presenting EE, were enrolled, with 61.3% of the teeth in the SC group. Sex of children with EE and distribution of EE were not relevant to the IRR outcome. The presence of supernumerary teeth might be a protective factor for the IRR outcome. The increasing severity of root resorption in the second primary molar indicated an IRR outcome. A higher MOII and a larger EA suggested an IRR outcome with moderate-to-high quality. The horizontal distance exhibited debatable results, with a low predictive quality.
Close monitoring and early intervention would benefit children with increasing severity of distal atypical resorption in the second primary molar, higher MOII, and larger EA.
本研究旨在分析导致第一恒磨牙不可逆行异位萌出(IRR)的可能因素,并探讨 IRR 结局的潜在预测因素。
本研究选择了至少有 1 颗异位萌出且在 8 岁之前拍摄了首次全景片的 4-11 岁儿童。将受试者分为自行矫正(SC)组和 IRR 组。记录患者的年龄、性别、异位萌出的分布情况以及伴发的牙齿异常。在全景片上测量第一恒磨牙的萌出角度(EA)、第二乳磨牙的根吸收程度、嵌塞指数(MOII)的大小和水平距离。使用卡方检验和独立样本 t 检验分别对名义变量和连续变量进行分析。采用受试者工作特征曲线确定临界值。
共纳入 406 名儿童的 634 颗第一恒磨牙,其中 61.3%的牙齿在 SC 组。异位萌出儿童的性别和异位萌出的分布与 IRR 结局无关。多生牙的存在可能是 IRR 结局的保护因素。第二乳磨牙根吸收程度的加重预示着 IRR 结局。较高的 MOII 和较大的 EA 提示 IRR 结局为中高度质量。水平距离的预测结果存在争议,预测质量较低。
对于第二乳磨牙远中异常吸收程度加重、MOII 较高和 EA 较大的儿童,密切监测和早期干预将有利于其治疗。