This is the 3873 article of Dayi Xiaohu
Xiaofang is in the fourth grade of elementary school this year. Like other children, he lives a carefree life, but the results of his recent school physical examination have made his whole family worried. It turned out that Xiaofang's upper right deciduous incisor had been missing for more than three years and showed no signs of growth. By coincidence, a classmate of my class was undergoing early orthodontic treatment at the Dental Hospital Affiliated to Tongji University. Xiaofang's family came to the orthodontic department for a detailed examination before the Chinese New Year. The doctor found that Xiaofang's upper right central incisor, lateral incisor , and canine were not visible in the oral cavity. There was also a moderately loose deciduous canine in the upper right side.
The doctor took X-rays of Xiao Fang and found that Xiao Fang’s three upper right front teeth were wrapped in a ball shape in the alveolar bone, balancing each other. No wonder they never grew back!
The doctor said that Xiaofang’s situation is an “impacted tooth”, which occurs in 4-14% of the population. It is particularly rare for Xiaofang’s situation where all three teeth have not erupted. So how to treat it next? The doctor suggested that in Xiao Fang’s case, the buried teeth should be pulled into the mouth one by one as soon as possible to avoid more serious consequences. However, the treatment time is long, expected to be two to three years, and there is root resorption and there may be a small amount of loosening of the teeth after tooth extraction. After repeated consideration, in order to prevent the small square front teeth from becoming " dentures " in the future, the family members unanimously agreed to undergo treatment.
During the treatment, the doctor took a three-dimensional CBCT of Xiaofang. Through three-dimensional reconstruction, he clarified the growth direction and adjacent relationship of each tooth, and determined the order of orthodontic traction. Then, work with the oral and maxillofacial surgeon to clarify the location, sequence and time of opening the window for the impacted teeth. After a period of hard work, Xiaofang's teeth miraculously grew out one by one.
After one and a half years of treatment, Xiaofang’s upper right canine and lateral incisor were successfully integrated into the dental arch; CBCT showed that the upper right central incisor was in a palatal position and required labial traction. After another year of orthodontic treatment, the three teeth were finally restored to the dental arch.
Coincidentally, Xiao Wang went to the hospital for an examination because his deciduous tooth had not fallen out for a long time, and he accidentally found that the lower right second premolar was lying across the alveolar bone. The X-ray showed that the lower right second premolar was impacted horizontally, the root development was only half of that of the normal tooth with the same name, and the crown of the lower right first molar was tilted.
Undoubtedly, Xiao Wang’s situation is also quite complicated. If not treated, the root of this impacted tooth will have problems, and it will face the risk of extraction in the future. Treatment means the possibility of a long-term battle. In the end, after a team of orthodontists, pediatric dentists, and oral surgeons worked together, as well as Xiao Wang’s close cooperation, it took nearly more than a year to finally install the impacted tooth in the correct position.
So how to judge whether the child's teeth are erupting normally?
. In most cases, there is a certain correlation between dental age and physiological age. The upper and lower four incisors erupt at 7-8 years old, while the canines and premolars often grow at 9-11 years old. . The lower teeth erupt earlier than the upper teeth. . The eruption time of teeth with the same name on both sides is relatively synchronized. If you find that your child has trouble erupting teeth, you need to go to the orthodontic department for examination as soon as possible to avoid missing the best opportunity for treatment.
Department of Orthodontics, Tongji University Stomatological Hospital
Written by: Zhao Yanhui
Reviewer: Liao Chongshan
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All names and place names are pseudonyms. Any similarity is purely coincidental.
