하악 절치부에 발생한 과잉치

마연주,이제호,송제선,최병재,김성오 大韓小兒齒科學會 2009 대한소아치과학회지 Vol.36 No.4

소아치과 영역에서 치아수의 이상은 흔히 관찰할 수 있으며, 그 중 대표적인 것의 하나가 과잉치이다. 과잉치의 발생원인에 대해서는 여러가지 가설이 있으며 유전적 또는 환경적 요인에 의해 치배 형성기의 정상 치판이 과도하게 증식하여 발생되는 것으로 알려져 있다. 과잉치가 가장 흔하게 발생되는 부위는 상악에서는 절치부로 그 빈도는 80-94% 정도로 보고되고 있고 그 다음으로는 구치부와 소구치부 순서로 나타난다. 상악에 비해 하악에서는 대부분 소구치 부위에서 발생되며 절치부에서는 전체 과잉치 발생빈도 중 단지 1-2% 이하로 매우 낮은 빈도로 발생되는 것으로 보고되고 있다. 이 증례는 드물게 나타나는 하악 절치부에 2개의 과잉치가 있다는 주소로 내원한 만 6세 남아에서, 임상 및 방사선학적 검사 결과 하악 절치부에 정상치와 크기와 형태가 비슷한 정상치형의 과잉치 2개를 포함하여 6개의 절치가 존재하는 것이 관찰되었다. 발치할 치아의 정확한 진단 및 결정을 위해 컴퓨터 단층 촬영을 시행하였고 발치 후 하악 전치부의 정상적인 배열을 위해 치아 맹출에 대한 주기적 정기 검진 후 교정적 평가와 치료를 진행할 예정이다. Pediatric dentists often meet children with abnormal in number of tooth. Presence of supernumerary teeth is frequent cause of malocclusion. Etiology for supernumerary teeth is not yet clearly defined, but it is thought to be caused by excessive proliferation of dental lamina by hereditary and environmental factors. Supernumerary teeth occur in the maxilla nine times more frequently than in the mandible. Most common supernumerary tooth is the mesiodens in the maxilla, and some are observed in the maxillary molar and mandibular premolar. It occurs rarely in the mandibular incisor region with the incidence of 1-2% among all supernumerary teeth. A six-year old boy visited the department of the pediatric dentistry, Yonsei University Dental Hospital, with the chief complaint of crowded supernumerary teeth on the mandibular incisor region. Clinical and radiographic examinations revealed six permanent mandibular incisors similar in size, shape, and length. Further investigation using computed tomography(CT) was proceeded on the mandible to measure and compare morphologic features and positions of the six incisors. Then, we decided to remove two incisors which were already erupted. Periodic check-up was followed to monitor the dental development and spontaneous positional enhancement of the remaining four incisors in the mandible.

영유아기 과잉치의 임상적 처치 및 micro-computed tomography 분석: 증례 보고

나채현,이한아,김한성,김지훈 대한소아치과학회 2022 대한소아치과학회지 Vol.49 No.3

Supernumerary teeth develop from excessive proliferation and development of the dental lamina. Supernumerary teeth can cause several problems, including ectopic eruption, delayed eruption, root resorption of adjacent teeth, and diastema. Supernumerary teeth in infancy are rare and have rarely been reported. Case of a 2-day-old infant with 3 supernumerary teeth is presented here and the patient was followed up for 21 months. The erupted supernumerary tooth in the primary dentition was extracted under moderate sedation at the age of 14 months. Microcomputed tomography analysis of the extracted tooth confirmed microscopic root malformation. After extraction, the midline diastema was reduced and oral hygiene improved. Early diagnosis and prompt treatment can prevent complications of supernumerary teeth.

상악 유측절치 부위의 유치 과잉치에 관한 증례보고

최병재,한효정,이제호,김성오,손흥규 大韓小兒齒科學會 2006 대한소아치과학회지 Vol.33 No.1

과잉치란 치배 형성기 이상으로 유치열기와 영구치열기에 정상보다 많이 발생하게 된 치아를 말한다. 유치 과잉치의 빈도는 0.03~1.9%로 상악 유측절치 부위에 호발하고 대부분은 정상 치아 형태로 맹출하며 정상 시기에 탈락하므로 보호자들이 인식하지 못하는 경우가 많다. 과잉치의 발생에 대해서는 현재 치판의 과활성으로 인해 제 3의 치배가 발생한다는 가설이 널리 받아들여지고 있고 유치과잉치가 발생할 경우 영구치열기에는 정상 또는 비정상적인 형태의 계승 과잉치가 존대한다고 보고된 바 있다. 유치 과잉치의 약 75%는 정상적으로 맹출하고 탈락하기 때문에 특별한 처치는 필요하지 않지만 계승 영구치 맹출에 영향을 주는지를 관찰하기 위하여 정기적인 구강 및 방선학적 검사가 필요하다. 본 두 증례의 경우 정상 치아 형태의 유치 과잉치가 유전치부 발육 공간을 이용하여 상악 유측절치 부위에 맹출하였고 방사선 사진 검사 결과 유치 과잉치 하방에 매복된 계승 과잉치가 관찰되었으므로 이에 보고하는 바이다. Most supernumerary primary teeth erupt in the primary lateral incisor region and are reported to occur in 0.03 to 1.9% in the primary dentition. Most parents fail to recognize them because of their normal shape, eruption and exfoliation. Several theories have been proposed for the etiology of hyperdontia and the dental lamina hyperactivity theory is most widely accepted. When a supernumerary primary tooth develops. it is reported that there also exists a supplemental or rudimentary form of a succedaneous supernumerary tooth. Supernumerary primary teeth do not need specific treatment as 75% of them erupt and exfoliate normally. Only periodic radiographic exams are necessary to find out whether there is any problem with the eruption of the succedaneous tooth. In the following two cases, a supplemental supernumerary primary tooth with a loss of the anterior developmental space was observed at the maxillary lateral incisor region. Radiographic examination revealed an impacted succedaneous supernumerary tooth at the palatal side of the supernumerary primary tooth.

유치의 융합과 연관된 하악 전치부의 과잉치 : 증례 보고

윤수미(Soo-mi Yun),라지영(Ji-young Ra),이제우(Je-woo Lee) 대한치과의사협회 2020 대한치과의사협회지 Vol.58 No.7

Odontogenic anomalies can occur as a result of conjoining defects. These include fusion, gemination and concrescence. The presence of fused teeth can lead to various clinical problems, including the aplasia of permanent successor, the supernumerary teeth and delayed eruption of permanent teeth. In general, the supernumerary teeth associated with fusion is mainly found in the maxillary anterior region. This report describes rare cases of supernumerary tooth associated with fused teeth of mandibular primary lateral incisor and canine. In the first case, fused teeth was extracted. The supernumerary teeth was erupted at canine space. The second case is still being observed. Extraction of fused teeth and observation of supernumerary teeth is planned.

다수의 매복치 및 과잉치를 동반한 쇄골두개이형성증 환자에서 골내고정원 및 악간견인을 이용한 교정치료

김하림(Harim Kim),천주희(Joo-He Chun),조웅기(Ung Ki Cho),이기준(Kee-Joon Lee) 대한구순구개열학회 2022 대한구순구개열학회지 Vol.25 No.1

Cleidocranial dysplasia (CCD) is a genetic skeletal condition with autosomal dominant inheritance. It is characterized by various skeletal and dental abnormalities, such as missing clavicles, hypoplastic maxilla, retained deciduous teeth, and supernumerary and impacted permanent teeth. In such patients forced eruption of impacted teeth tends to be challenging due to the limited osteogenesis. The present case illustrates the orthodontic and surgical management of a 15-year-old female patient with CCD accompanied by multiple supernumerary and impacted teeth using intermaxillary traction and bone-borne anchorage. After the surgical opening of the impacted teeth, a miniscrew-assisted rapid palatal expander (MARPE) was delivered in combination with a facemask for anteroposterior and transverse development of the maxilla. Following the maxillary expansion, a fixed appliance was bonded sequentially, first in the maxilla and then in the mandible for space regaining and eruption of the impacted teeth. Supernumerary teeth were removed successively during the treatment. The treatment was completed after 31 months with successful eruption and alignment of the impacted teeth, and the 3-year-follow-up showed satisfactory posttreatment stability. As shown in the present case, early diagnosis and timely orthodontic and surgical interventions are crucial to avoid further skeletal and dental complications and to facilitate aesthetic and functional rehabilitation in patients with CCD.

상악 측절치에 발생한 보충치형의 과잉치 : 증례보고

정미상,현홍근,김영재,장기택,이상훈,김종철,한세현,김정욱 大韓小兒齒科學會 2011 대한소아치과학회지 Vol.38 No.1

치배형성기 발육 이상으로 유치열이나 영구치열에서 정상보다 많이 발생하게 된 치아를 과잉치라 한다. 과잉치는 형태에 따라 정상 치아와 형태가 비슷한 보충치(supplementary tooth)와 형태가 다른 흔적치(rudimentary tooth)로 나눌 수 있 다. 대부분의 과잉치는 흔적치의 형태를 가지며 보충치는 드물게 나타난다. 보충치는 상악 측절치 부위에서 호발하며 정상 전 치와 유사한 형태와 크기를 갖기 때문에 진단시 특별히 주의를 기울여야 한다. 미맹출 과잉치는 상악 전치의 맹출 장애 및 전 위, 치간 이개, 치근 흡수, 낭종 형성 등의 합병증을 유발할 수 있으므로 조기에 진단하고 치아 배열 상태 및 치아 발육 단계 에 따라 적절한 치료를 시행하는 것이 중요하다. 본 3 증례는 상악 측절치부에 편측 혹은 양측으로 보충치 형태의 과잉치를 갖는 증례로서 맹출 관찰 및 외과적 발거, 교정 치료 및 레진 수복을 통해 치료하였다. Supernumerary teeth are in excess of the normal number of teeth in either the primary or permanent dentitions. They are classified into supplemental teeth resembling those of the normal series and rudimentary teeth with abnormal shapes, according to their form. Most of the supernumerary teeth are rudimentary form, and supplemental teeth are much less common. Sulppemental teeth are most common in the permanent maxillary lateral incisor area and clinicians should be careful with differential diagnosis from normal teeth. Unerupted supernumerary teeth may produce several complications such as delayed eruption, displacement of permanent teeth, diastema, root resorption and cyst formation. Early detection and proper treatment plan according to the tooth alignment and root formation stage are important. Here we report 3 cases of unilateral or bilateral normal incisor shaped supernumerary lateral incisors treated by eruption observation, surgical extraction and orthodontic treatment with resin build-up.

3D Dental-CT를 이용한 상악 매복 과잉치의 진단 : 증례보고

김재곤,김수경,양연미,백병주,김성희 大韓小兒齒科學會 2006 대한소아치과학회지 Vol.33 No.1

과잉치는 법랑기(enamel organ)가 치배형성을 지속하거나 과도한 세포증식을 함으로써 발생한다. 과잉치는 상악 전방부에서 종종 발견되며, 유치열기와 혼합치열기에서 다양한 문제를 야기한다. 과잉치는 형태에 따라서 보충치(supplemental tooth)와 흔적치(rudimental tooth)로 나눌 수 있다. 보충치는 정상 절치와 크기 및 형태가 유사하나, 흔적치는 비정삭적인 형태와 작은 크기를 갖고 있다. 보충치는 영구 측절치 부위에서 호발하며 정상 전치와 유사한 형태와 크기를 갖고 있으므로, 발치시 주의를 기울여야 한다. 본 3증례는 상악 전방부에 정상 전치 형태의 과잉치를 갖는 증례들이다. 모든 증례에서, 치근단, 교합, 파노라마 방사선 사진 등의 기존 방사선 사진 촬영 외에 3Dimensional Dental-Computed Tomography(3D Dental-CT)를 촬영하여 진단하였다. 기존 일반 방사선 사진들(conventional radiographs)과 3D Dental-CT를 비교시, 일반 방사선 사진들은 2차원적인 영상만을 제공하여 상의 해석에 있어서 술자의 주관이 개입되는 한계가 있다. 반면 3D Dental-CT는 과잉치의 정확한 위치와 형태에 대한 객관적인 정보를 제공하며, 좀 더 보존적인 수술을 시행하고, 수술 시간과 스트레스를 줄이는데 유용하다. 그러므로 일반 방사선 사진 촬영 후 과잉치의 위치가 불분명하고 인접 영구치의 손상이 의심되는 경우 3D Dental-CT를 이용한 진단이 고려된다. Supernumerary teeth are teeth which result from the continued budding of the enamel organ of the preceding tooth or from excessive proliferation of cells. They are most often found in the maxillary anterior region. And they can be responsible for a variey of irregularities in the primary and transitional dentition. There are two morphological types of supernumerary teeth: supplemental and rudimentary. Supplemental teeth have normal shape and size. In contrast, rudimental teeth have abnormal shape and smaller size. Supplemental supernumerary teeth are most common in permanent lateral incisor area. Its extration must be decided more carefully with differential diagnosis between normal teeth, because it has nomal shape and size. We reports 3 cases of the normal incisor shaped teeth in the maxillary anterior region. In all cases, we used the 3D Dental-CT as well as the conventionl plain film such as periapical, occlusal, and panoramic ridiograph. Consequently, 3D Dental-CT was valualble to figure out the exact position and morphology of supernumerary teeth, to do more conservative surgery, and to reduce surgery stress and time.

매복과잉치 및 영구치 동시 발거 후 임플란트의 즉시 식립 증례

권준,윤규호,박관수,정정권,신재명,최민혜,나혜정,Kwon, Jun,Yoon, Kyu-Ho,Park, Kwan-Soo,Cheong, Jeong-Kwon,Shin, Jae-Myung,Choi, Min-Hye,Na, Hye-Jung 대한악안면성형재건외과학회 2009 Maxillofacial Plastic Reconstructive Surgery Vol.31 No.4

Supernumerary teeth are extra teeth or tooth-like structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Clinicians sometimes confront unerupted supernumerary teeth where implants would be placed. Many clinicians consider immediate placement of implant into an extracted socket as an effective technique compared to the conventional method of waiting several months for bone healing, because of the advantages such as reduction of treatment period, preservation of alveolar bone and soft tissue, etc. We could hardly find the case of immediate placement of implant after extraction of impacted supernumerary teeth and permanent teeth together. Therefore we report the case of immediate implantation following extraction of impacted supernumerary teeth and poor periodontal conditioned permanent teeth.

오훼돌기에 매복된 과잉치: 증례보고

박원서,이제호,박혁,정호걸,김기덕,Park, Won-Se,Lee, Je-Ho,Park, Hyok,Jung, Ho-Gul,Kim, Kee-Deog 대한영상치의학회 2010 Imaging Science in Dentistry Vol.40 No.2

Impaction of tooth is a situation in which an unerupted tooth is wedged against another tooth or teeth or otherwise located so that it cannot erupt normally. The supernumerary tooth is also called as hyperdontia and defined as the condition of having additional tooth to the regular number of teeth. The most common supernumerary tooth is a mesiodens, which is a mal-formed, peg-like tooth that occurs between the maxillary incisors. The supernumerary tooth is commonly impacted but they are frequently impacted on maxilla. Ectopic impaction of supernumerary tooth on mandibular condyle, coronoid process, ascending ramus, and pterygomandibular space is very rare condition. In this case, we report a case of impacted supernumerary tooth on mandibular sigmoid notch without definite pathologic change.

Supernumerary teeth in non-syndromic patients

Mali, Santosh,Karjodkar, Freny Rashmiraj,Sontakke, Subodh,Sansare, Kaustubh Korean Academy of Oral and Maxillofacial Radiology 2012 Imaging Science in Dentistry Vol.42 No.1

Hyperdontia or supernumerary teeth without associated syndrome is a rare phenomenon, as supernumerary teeth are usually associated with cleft lip and palate or other syndromes such as Gardner's syndrome, cleidocranial dysplasia, and so on. Five patients with supernumerary teeth visited our department. They had no familial history or other pathology, certain treatment protocols was modified due to the presence of supernumerary teeth. Non-syndromic supernumerary teeth, if asymptomatic, need to have periodical radiographic observation. If they showed no variation as they impacted in the jaw, careful examination is necessary because they may develop into pathological status such as dentigerous cysts. The importance of a precise clinical history and radiographic examination for patients with multiple supernumerary teeth should be emphasized.