埋伏四十年的正中多生牙的临床表现及预后

doi:10.3877/cma.j.issn.1674-1366.2015.06.012

中华口腔医学研究杂志(电子版) ›› 2015, Vol. 09 ›› Issue (06) : 497 -500. doi: 10.3877/cma.j.issn.1674-1366.2015.06.012

所属专题：经典病例；文献；

病例报告

埋伏四十年的正中多生牙的临床表现及预后

何绮芬¹, 李春阳¹^,^†(

)

^1. 519000　珠海，中山大学附属第五医院口腔科

收稿日期:2015-08-11 出版日期:2015-12-01
通信作者: 李春阳

The clinical representation and outcome of a 40-year mesiodens

Qifen He¹, Chunyang Li¹^,^†()

^1. Department of Stomatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China

Received:2015-08-11 Published:2015-12-01
Corresponding author: Chunyang Li
About author:
Corresponding author: Li Chunyang, Email: lichyang@mail.sysu.edu.cn

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目的

探讨并报道1例埋伏正中多生牙的长期破坏力、临床表现和治疗效果。

方法

通过临床检查和拍摄X线片发现1例47岁女性患者的垂直倒置的正中多生牙，在上颌骨前牙区形成了含牙囊肿及由它而引发的右上中切牙牙周牙髓的联合病变以及上前牙间的不规则间隙。对此患者进行了右上中切牙的牙周牙髓联合治疗、囊肿摘除、多生牙拔除，并进行了跟踪随访，文献回顾分析。

结果

本例显示埋伏正中多生牙对邻近组织的长期破坏产生的影响不能完全恢复正常。治疗只是一定程度上改善受累邻牙的牙周状况。

结论

正中多生牙应及时发现并及时干预，否则正中多生牙的破坏力持续存在、不可逆转。

关键词: 正中多生牙, 含牙囊肿, 牙周牙髓联合病变

Objective

To show the long term destroying power of an embedded mesiodens and its outcome.

Methods

A rare and uncommon case happened in a 47-year-old female with mesiodens was reported. The periodontal-endodontic combined lesions in right central incisor, triangular gap between the two central incisors and right lateral incisor caused by a vertical but inverted labially located mesiodens with a dentigerous cyst were diagnosed by clinical examination and radiograph. Periodontal-endodontic treatment, cystectomy, extraction and follow-up of the embedded mesiodens were done. The related literatures were reviewed.

Results

The long-term damage on the adjacent tissues caused by the embedded mesiodens could not be reversed. The proper treatments can improve periodontal status to a certain extent. This 47-year female is the eldest patient with mesiodens that has ever reported.

Conclusion

This rare case provided evidence to support that early discovery and intervention are needed for embedded mesiodens. It concluded that the destroying power of mesiodens could last for long time.

Key words: Mesiodens, Dentigerous cyst, Periodontal-endodontic combined lesion

图1 上颌正中多生牙患者根尖X线片

图2 上颌正中多生牙患者口腔全颌曲面断层片

图3 上颌正中多生牙患者在正中多生牙拔除术前

图6 上颌正中多生牙患者多生牙拔除和囊肿摘除后术区情况（多生牙拔除后，可见拔牙窝与中间的空腔相通）

图7 上颌正中多生牙患者多生牙拔除和囊肿摘除术后2个月

图8 上颌正中多生牙患者右上中切牙根管治疗加多生牙拔除术后2个月根尖X线片

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[1]	李璟, 刘娟, 梁菁, 谭凤清, 徐婷, 曾雄群. 牙周牙髓联合病变的综合治疗效果观察[J]. 中华口腔医学研究杂志(电子版), 2019, 13(06): 349-354.

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The clinical representation and outcome of a 40-year mesiodens

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The clinical representation and outcome of a 40-year mesiodens