Jiang W, Wang M, Shen M, Han J, Xu L, Wu Z
Department of Pediatric Dentistry, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang Provincial Engineering Research Center for Oral Biomaterials and Devices.
Eur J Paediatr Dent. 2024 Oct 1:1. doi: 10.23804/ejpd.2024.2235.
Infraocclusion refers to a tooth located below the occlusal surface compared to adjacent teeth long after it should have reached occlusion. Ankylosis is frequently associated with the infraocclusion of primary molars, but it is challenging to distinguish between the two conditions. Surgical luxation and orthodontic traction have been applied for the treatment of ankylosed, infraoccluded permanent teeth, but reports on primary molars are scarce.
A 5-year-old boy presented with a severely infraoccluded primary mandibular second molar with deep caries. A partial pulpotomy was performed to treat the affected tooth when the pulp was exposed after caries removal. A combination of surgical luxation and orthodontic tractionwas performed for the affected tooth, and after 5 months, the tooth successfully erupted to the occlusal level. During the follow-up period of two years, no complications were observed.
This report identified that surgical luxation, in conjunction with orthodontic traction, is effective and feasible for severely infraoccluded primary teeth. Additionally, partial pulpotomy may be an alternative for vital pulp therapy on primary teeth.
低位阻生是指一颗牙齿在本应萌出到咬合平面很久之后，其位置仍低于相邻牙齿的咬合面。乳牙粘连常与乳牙低位阻生相关，但区分这两种情况具有挑战性。外科松动术和正畸牵引已被应用于治疗粘连性低位阻生恒牙，但关于乳牙的报道较少。
一名5岁男孩因下颌乳第二磨牙严重低位阻生且伴有深龋前来就诊。在去除龋坏组织后牙髓暴露时，对患牙进行了部分牙髓切断术。对患牙联合实施了外科松动术和正畸牵引，5个月后，患牙成功萌出至咬合平面。在两年的随访期内，未观察到并发症。
本报告表明，外科松动术联合正畸牵引对于严重低位阻生乳牙是有效且可行的。此外，部分牙髓切断术可能是乳牙活髓治疗的一种替代方法。
