심하게 변위된 유전치 치근파절의 보존적 접근
Conservative approach on the severely displaced root fracture of primary incisors : Case report
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초록
유치열에서의 치근파절은 유치열의 손상 유형 중 2~7% 정도를 차지하고 생리적 치근흡수가 시작하는 3~4세 쯤 흔히 나타난다. 파절선의 위치에 따라 치근단 ⅓, 중간 ⅓, 치경부 ⅓으로 분류되며 치경부 ⅓에서의 치근파절이 예후가 가장 불량하다. 유치의 치근파절이 발생한 경우 파절편의 변위가 적고 감염의 소견이 없으면 영구치의 경우와 같이 2~3개월의 선부자고정으로 치료할 수 있으나, 파절편의 동요 및 변위가 심하거나 선부자고정을 할 수 없을 때에는 치관부 파절편은 제거하고 영구치배의 안전을 위해 치근부 파절편은 잔존시킨다. 본 증례는 유전치의 치근파절이 발생하여 치관부 파절편의 변위가 심한 경우에서 발치하지 않고 정복 후 선부자 고정을 1~3개월 간 시행하고, 파절편의 동요, 동통, 치수괴사, 감염 등의 증상없이 치유되는 양호한 결과를 얻었기에 보고하고자 한다.
Abstract
Root fracture of primary teeth is relatively uncommon because the more pliable alveolar bone allows displacement of the tooth. Root fracture of primary teeth is occupied 2~7% in trauma pattern of primary teeth. A horizontal root fracture is classified based on the location of the fracture in relation to the root tip : the apical third, middle third, or cervical third of the root. The prognosis worsens the further cervically the fracture has occurrer. Root fracture of primary teeth should be treated by splinting the incisor to the adjacent normal teeth with a resin-wire splint for 8~12 weeks. However, if a portion of the root is abscessed or extremely mobile, it can be extracted, and the remaining root fragment will resorb normally. For coronal third fracture in primary teeth, the coronal third is extracted, leaving the apical portion of the root to resorb normally. These root fracture cases of primary teeth were treated by resin-wire splinting despite extremely mobile coronal fragment. Even though they seems like healing well, They need to be monitored regularly until their successors erupt.
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