Urechescu Horatiu, Banu Ancuta, Streian Felicia, Urtila Florin, Cuzic Cristiana, Dinu Stefania, Pricop Marius
Department of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy "Victor Babes", 300041 Timisoara, Romania.
Department of Prosthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy "Victor Babes", 300041 Timisoara, Romania.
J Clin Med. 2024 Dec 22;13(24):7831. doi: 10.3390/jcm13247831.
The most common form of supernumerary teeth is represented by the mesiodens. Very often, they are impacted, usually palatially, but can be found buccally or between the roots of the permanent central incisors. Their position can be normal, inclined, or inverted. In the possible case where the impacted mesiodens crown is oriented upwards towards the nasal cavity, they are called inverted mesiodens. The inverted mesiodens are mainly asymptomatic, and the main diagnostic methods are radiological, especially CBCT. This paper presents the intraoral approach through the nasal floor as a very reliable method for the surgical removal of inverted mesiodens. We report a protocol, including the diagnosis process, criteria for choosing this surgical approach, and description of the surgical procedure. Preoperative CBCT is mandatory for diagnosis and choice of the surgical approach. This is chosen based on measurements on the cross-sectional view of the CBCT investigation and is in compliance with our criteria related to the appropriate surgical approach. Using this approach, the mesiodens were extracted without intraoperative or postoperative complications or accidents, and operating times were relatively short. The intraoral approach through the nasal floor for surgical removal of inverted mesiodens satisfies all the conditions to be a predictable, safe, and time-efficient technique. It has its limitations, mainly regarding the surgical skills of the operating team. The cone-beam computed tomography (CBCT) has a fundamental role in the diagnosis and treatment of included mesiodens.
额外牙最常见的形式是正中牙。它们常常埋伏阻生，通常位于腭侧，但也可能出现在颊侧或恒中切牙牙根之间。其位置可以是正常的、倾斜的或倒置的。在埋伏阻生的正中牙牙冠向上朝向鼻腔的可能情况下，它们被称为倒置正中牙。倒置正中牙主要无症状，主要诊断方法是影像学检查，尤其是锥形束计算机断层扫描（CBCT）。本文介绍了经鼻底的口内入路，这是一种非常可靠的倒置正中牙手术拔除方法。我们报告了一个方案，包括诊断过程、选择这种手术入路的标准以及手术过程的描述。术前CBCT对于诊断和手术入路的选择是必不可少的。这是根据CBCT检查横断面视图上的测量结果选择的，并且符合我们与合适手术入路相关的标准。采用这种方法，正中牙被拔除，术中及术后均无并发症或意外发生，手术时间相对较短。经鼻底的口内入路用于倒置正中牙的手术拔除满足成为一种可预测、安全且高效的技术的所有条件。它有其局限性，主要涉及手术团队的手术技能。锥形束计算机断层扫描（CBCT）在埋伏正中牙的诊断和治疗中起着重要作用。
