Ericson S, Kurol J
Am J Orthod Dentofacial Orthop. 1987 Jun;91(6):483-92. doi: 10.1016/0889-5406(87)90005-9.
This study analyzes the need for and possibility of obtaining further information from different radiographic procedures in 125 children with potential ectopic eruption of the maxillary canines. After clinical examination of 3,000 10 to 15-year-old children, it was found that 7% needed radiographic examinations for determination of the canine position. Eighty-four children (2.8%), with a total of 125 potential ectopically erupting maxillary canines diagnosed clinically and by means of periapical radiographs, were selected and a stepwise extended radiographic diagnostic procedure was used. Most canines in ectopic eruption were positioned palatally; the positions could be assessed with sufficient accuracy from conventional periapical films in 92% of the cases. Only in 37% of the cases, however, could the lateral incisor be projected free from the ectopic canine by the intraoral technique. The lamina dura of the lateral incisor facing the canine was often found to be interrupted. For 29% of the ectopic canines, the lateral incisors could neither be projected free nor judged free from resorptions and a supplementary polytomographic investigation was believed to be necessary. The number of resorbed teeth was doubled by polytomography and altogether 12.5% of the ectopic canines caused resorptions. A stepwise radiographic procedure including polytomography is described and recommended in cases of ectopic eruption of maxillary canines for determining the correct position and ruling out or confirming resorptions on incisors, thereby optimizing the orthodontic treatment planning.
本研究分析了125例上颌尖牙可能异位萌出的儿童通过不同影像学检查获取更多信息的必要性和可能性。在对3000名10至15岁儿童进行临床检查后,发现7%的儿童需要进行影像学检查以确定尖牙位置。选取了84名儿童(2.8%),共125颗临床上及通过根尖片诊断为上颌尖牙可能异位萌出的牙齿,并采用逐步扩展的影像学诊断程序。大多数异位萌出的尖牙位于腭侧;在92%的病例中,通过传统根尖片能够足够准确地评估其位置。然而,仅在37%的病例中,通过口内技术可使侧切牙投影不与异位尖牙重叠。常发现侧切牙靠近尖牙侧的硬骨板中断。对于29%的异位尖牙,侧切牙既无法投影不重叠,也无法判断无吸收,因此认为需要进行补充曲面断层检查。曲面断层检查使吸收牙的数量增加了一倍,共有12.5%的异位尖牙导致吸收。本文描述并推荐了一种包括曲面断层检查在内的逐步影像学检查程序,用于上颌尖牙异位萌出的病例,以确定正确位置,并排除或确认切牙的吸收情况,从而优化正畸治疗方案。