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DOI: 10.1055/s-2006-921544
© Georg Thieme Verlag
Impaktierte obere Eckzähne - eine Literaturübersicht
Maxillary Canine Impaction - A Review of the LiteraturePublication History
Publication Date:
23 March 2006 (online)
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Zusammenfassung
Der obere Eckzahn ist mit einer Prävalenz von 0,8-3,3 % der zweithäufigste impaktierte Zahn nach dem Weisheitszahn. Zwei Theorien zur Ätiopathogenese der Impaktion oberer Eckzähne werden in der Literatur angeführt: die Führungstheorie und die genetische Theorie. Häufig sind hypoplastische oder nicht angelegte seitliche Schneidezähne, Nichtanlagen der zweiten Prämolaren oder infraokkludierende Milchmolaren mit einer Eckzahnimpaktion assoziiert. Die Diagnose der Eckzahnimpaktion erfolgt auf drei Ebenen: Klinischer Inspektion, Palpation und mit Hilfe bildgebender Verfahren. Bei Patienten ohne Engstand ist die Extraktion des Milcheckzahnes eine Möglichkeit, um die Wahrscheinlichkeit einer Eckzahnimpaktion zu reduzieren. Wurzelresorptionen an den zentralen und seitlichen Schneidezähnen treten häufig im Zusammenhang mit impaktierten Eckzähnen auf. Nur die Computertomographie ermöglicht die exakte Darstellung von Wurzelresorptionen. Vor der chirurgischen Freilegung ist die Rücksprache mit dem Oralchirurgen bezüglich der Freilegungstechnik von besonderer Bedeutung, um Rezessionen oder eine verlängerte Behandlungsdauer zu vermeiden. Nach der chirurgischen Freilegung wird orthodontisch Zug auf den Zahn ausgeübt. Seit der Einführung der Ballista spring sind viele Hebelarmmechaniken zur initialen Extrusion eines impaktierten Zahnes beschrieben worden. Dieser Artikel soll die moderne Diagnostik und aktuelle Therapiemodalitäten der Eckzahnimpaktion zusammenfassen.
Abstract
The maxillary canine is second only to the third molar in frequency of impaction, with a prevalence of 0.8 to 3.3 %. There are two theories explaining palatal canine impaction: the “guidance theory” and the “genetic theory”. Still, the reason for canine impaction is unknown. Dental features associated with palatal canine impaction are small size of upper lateral incisors (hypoplasia), agenesis of upper lateral incisors, agenesis of second premolars and infraocclusion of primary molars. Diagnosis of canine impaction is based on visual inspection, palpation and radiography. In cases without arch length discrepancy, early deciduous canine extraction is a suitable way to prevent canine impaction. Root resorptions of the lateral and central incisors often occur when palatal canine impaction is present. Only computertomography accurately depicts root resorptions. Whenever surgical exposure of an impacted canine is needed the orthodontist should consider possible effects of different surgical techniques. After surgical exposure, orthodontic traction is applied to the impacted tooth. Since Jacoby introduced the “ballista spring”, many cantilever mechanics for initial extrusion have been described. The purpose of this article is to review current diagnosis and treatment of maxillary canine impaction.
Schlüsselwörter
impaktierter Eckzahn
Key words
impacted cuspid
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1 A3cc: Mitte der Eckzahnkrone; Cg vertical: Crista-galli-Vertikale (Mediansagittale); J: Jugal process- röntgentologischer Schnittpunkt der Außenkontur des Tuber maxillae mit dem Jochbogenpfeiler
DDr. M. Seemann
Abteilung für Kieferorthopädie · Bernhard Gottlieb Universitätszahnklinik Wien
Währingerstr. 25 a
1090 Wien
Österreich
Phone: +43/1/4 27 76 71 12
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Email: seemann_maximilian@gmx.at