歯冠象牙質吸収がみられた埋伏下顎第一大臼歯の萌出誘導

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  • Guidance for Eruption of the Impacted Mandibular First Permanent Molar with Intracoronal Dentin Resorption

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A 9 year-7 months-old girl was referred to the pediatric dental clinic, Tsurumi University Dental Hospital with a chief complaint of delayed eruption of the lower left first permanent molar.<BR>Radiographic findings at the first visit revealed an impacted and mesially tilted lower left first permanent molar with round radiolucency of approximately 4 mm in diameter in the mesio-buccal coronal dentin. The outline of the crown seemed normal.<BR>First, the lower left second premolar was extracted for creating the space for eruption of the lower left first permanent molar. Secondly the coronal part of the first permanent molar was surgically exposed. The mesially tilted first and second molars were then guided for their eruption by using a crown distal-shoe space maintainer set on the adjacent canine and first premolar, and the multibrackets appliance was used for the final alignment of the first and second permanent molars, which were uprighted and reached the occlusal plane.<BR>On the enamel surface of the erupted first permanent molar corresponding to the dentin resorption site, there was no defect or discoloration, and any uncomfortable symptoms to the teeth were not noticed clinically. The periodic radiographic examinations revealed no change of size and site of the dentin resorption, nor abnormal periodontal tissue, indicating the dentin resorption unlikely being a progressive lesion.

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