최근 5년간 시행된 치외치 치료에 대한 후향적 연구
A Retrospective Study on the Treatment of Dens Evaginatus for the Last 5 Years
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초록
본 연구의 목적은 소구치부에 발생한 치외치의 치료방법, 결과, 시기, 각 치료방법의 실패시 임상 증상과 징후 등에 대해 분석하는것이다. 연구에는 151명의 환자와 417개의 치아가 포함되었다. 치료방법에는 예방적 치료인 레진 수복, 직접 치수복조와 근관 치료인 치수재혈관화, 치근단 형성술, 전통적인 근관치료가 포함되었다. 예방적 레진 수복은 치외치 결절이 온전한 상태에서 성공적인 결과를 보였으며, 결절이 파절된 경우에도 효과적이었다. 직접 치수복조는 치근단 병소 없이 저작통만 존재할 때 임상 증상의 해소와 치근 성장을 보였다. 치수 재혈관화, 치근단 형성술, 전통적인 근관치료 시 가장 많이 나타난 치료 전 상태는 치근단 병소이었다. 치수 재혈관화는 대부분에서 성공적인 결과를 보였다. 하지만 일부에서 치근 길이 또는 치근벽 두께 증가가 나타나지 않은 경우가 있었다. 치근단 형성술과전통적인 근관치료는 모두 효과적이었다. 치외치의 예방적 치료 성공률을 높이기 위해 치외치가 교합력을 받지 않을 때이거나 온전한 결절이 존재하는 상태에서 레진 수복이시행되어야 한다. 결절이 파절된 경우 성공적인 치료를 위해서는 치근발육단계와 치수 상태가 고려되어야 한다.
Abstract
The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.
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