乳磨牙固连的研究进展  

Research progress on ankylosis of primary molars

作　　者：董宁 姜秋[1] DONG Ning;JIANG Qiu(Department of Pediatric Dentist-ry,Hospital of Stomatology,Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学口腔医院儿童口腔科,吉林长春130021

出　　处：《口腔疾病防治》2023年第5期370-374,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：吉林省自然科学基金项目(2019C051-4)。

摘　　要：乳磨牙固连是牙齿萌出异常的一种,固连部位牙周膜消失,表现为根骨黏连;发病率为1.3%~8.9%,乳牙列中最易受累牙位为下颌第一乳磨牙,混合牙列中为第二乳磨牙。乳磨牙固连病因可能与遗传因素、局部牙槽骨或牙骨质矿化代谢的相关信号通路、Malassez上皮剩余细胞分泌的细胞因子、牙根生理性吸收过程中的炎症反应等有关。乳磨牙固连可通过临床表现及影像学检查诊断,根据低位咬合程度分为轻、中、重度。因其可引起咬合紊乱、脱落延迟及牙槽骨发育不足等并发症,故需儿童口腔科、正畸科、牙周科、修复科等多学科联合治疗,综合考虑患者年龄、低位咬合严重程度及是否存在继承恒牙等因素制定长期治疗方案。本文就乳磨牙固连的病因、发病机制、诊断、并发症、治疗等方面进行综述,以期为乳磨牙固连的临床诊治提供参考。Ankylosis of primary molars is a kind of eruption abnormality of the teeth, where the periodontal membrane disappears, owing to a bony union between bone and root. Studies have shown that the common proportion of ankylosed primary molars is 1.3%~8.9% with an equal occurrence. In the primary dentition, the mandibular first primary molar is the most commonly affected tooth, while in the middle mixed dentition stage of development, the second primary molar is more affected. Its etiology may be related to genetics, signaling pathways of mineralization metabolism of local alveolar bone or cementum, cytokines secreted by epithelial rest cells of Malassez, and enhanced inflammatory reactions during physiological absorption of roots. Ankylosis of primary molars can be diagnosed by clinical symptoms and imaging and is classified as mild, moderate and severe according to the degree of infraocclusion. As it may cause a series of complications, such as occlusal disturbances, delayed exfoliation and incomplete alveolar process development, multidisciplinary treatment, including in the departments of pediatric dentistry, orthodontics, periodontics and prosthodontics,should be adopted, and long-term treatment is determined based on the patient’s age, severity of infraocclusion, and presence of permanent teeth. This review summarizes the etiology, diagnosis, complications and treatment of ankylosed primary molars to provide a reference for the clinical diagnosis and treatment of decidual molar fixation.

关 键 词：牙齿固连 乳磨牙 低位咬合 人牙周膜细胞 牙齿发育异常 WNT信号通路 Malassez上皮剩余细胞 核因子ΚB受体活化因子配体 

分 类 号：R78[医药卫生—口腔医学]