第二前磨牙先天缺失的病因及临床管理策略  

Etiology and clinical treatment strategies for second primary molars without permanent tooth germs

作　　者：袁国华[1] 王琰 Yuan Guohua;Wang Yan(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,Key Laboratory of Oral Biomedicine Ministry of Education,Hubei Key Laboratory of Stomatology,School&Hospital of Stomatology,Wuhan University,Wuhan 430079,China)

机构地区：[1]武汉大学口腔医(学)院、口颌系统重建与再生全国重点实验室、口腔生物医学教育部重点实验室、口腔医学湖北省重点实验室,武汉430079

出　　处：《中华口腔医学杂志》2024年第7期738-744,共7页Chinese Journal of Stomatology

基　　金：国家自然科学基金(82370913,82170914)。

摘　　要：先天性牙缺失是一类由于牙胚发育障碍导致牙齿数目减少的颌面部发育异常疾病。除第三磨牙外缺牙数目少于6颗称为个别牙缺失,其中第二前磨牙缺失最为常见。第二前磨牙缺失时,第二乳磨牙往往更易出现滞留、低位咬合、龋病甚至牙髓炎、根尖周炎等问题,若不及时进行恰当治疗,可对患者的牙齿排列、咬合功能、颌面部发育及后续修复治疗产生不利影响。本文总结了第二前磨牙缺失的病因、诊断特征,并以是否完全确诊第二前磨牙先天缺失为界,分别讨论无恒牙胚的第二乳磨牙保留或拔除的临床考量,以期为第二前磨牙牙胚缺失的临床诊疗提供参考。Congenital tooth agenesis is a type of craniofacial developmental anomaly with reduced number of teeth,which is caused by disturbances in tooth germ development.If the number of missing teeth is less than six(excluding the third molars),it is termed as hypodontia.The second premolars are most commonly affected.When the second premolars are missing,the second primary molars are more prone to suffer from retention,infraocclusion,caries,pulpitis,or periapical periodontitis.Without timely prevention and appropriate treatment,congenital loss of second premolars may cause adverse effects on the patients′tooth arrangement,occlusal function,craniofacial development,and even future prosthetic treatment.This review summarises the aetiological and diagnostic features of the agenesis of second premolars,and discusses the clinical considerations of retaining or extracting the second primary molars without permanent tooth germs,when the absence of permanent tooth germs is fully established or not,so as to provide references for dentists.

关 键 词：生长和发育 第二前磨牙 基因突变 间隙管理 临床管理策略 

分 类 号：R781.2[医药卫生—口腔医学]