Gömülü çürük süt azı dişinin cerrahi olarak çıkarılması

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Tooth impaction mean failure to erupt appears to be
due to physical and biological factors and the tooth remains unerupted beyond the normal time of eruption
(1). Impaction has been reported to be very rare in the
deciduous dentition. The most commonly impacted is
the decidious second molar followed by the maxillary
and mandibular central incisors, the primary canines
and the lateral incisors (2-6). When there is a clinical
absence of one or several teeth, and the history indicates that they have not been extracted, then partial
anodontia or tooth impaction should be considered.
Developmental disturbances as an anodontia can be
genetic or environmental factors. Trauma, precocious
eruption of the first permanent molar, congenitally
missing permanent teeth, defects in the periodontal
membrane, ankylosis, odontoma or a combination of
these factors may play role in the impaction of deciduous molar (7-9). The etiology of deciduous molar
impaction is still unknown and SEM studies of the
root surfaces of extracted secondary teeth have shown
most of these teeth to be anklyose (10).
Occurrence of the dentigerous cyst as a result of
unerupted deciduous teeth is extremely rarely reported in the literature (11). A dentigerous cyst encloses
the crown of an unerupted tooth, attaching to the
neck of the tooth and grows by expansion of its follicle. Dentigerous cysts may cause free large bone defects, the most common complication such as recurrent pericoronitis, cyst development, unrestorable caries. Consequently the preferable optimal treatment
is surgical extraction (12).
There have been some case reports about an impacted deciduous tooth, but only one case reported was
associated with reimpaction of deciduous molar in
literature. The aim of the present case report was to
deduce totally reimpacted maxillary deciduous molar
with caries in dentigerous cyst, considered as a rarity
in dental practice.Case Report
A 20-year-old male referred to our department with
a complaint of chronic infection in the maxillary
right premolar region. There was no history of trauma to maxillofacial region. Intra-oral examination
revealed the maxillary right first premolar tooth was
absent and the cusp of impacted maxillary right deciduous molar was observed (Figure 1). The occlusal
plane was noted in Class III molar relationship and
also maxillary right premolar and lateral, and right
permanent lateral teeth were absent. The family and
medical histories were non-contributory.
The impacted tooth and cyst were removed under
local anesthesia (Figure 3). During the surgery of
impacted deciduous tooth a minor communication
with the maxillary sinus was noticed. The wound was
closed with 3-0 silk suture material and the surgical
procedure was completed. There were no complications following surgery.
Histopathological examination revealed the dentigerous cyst. The presence of caries on the impacted
deciduous tooth indicates it has previously erupted.
Discussion
Impaction of deciduous molar is considered a very
rare phenomenon in the literature (4,10-13). Although
the majority of impacted teeth are seen in the permanent dentition, it is nearly uncommon in the deciduous dentition, with a reported prevalence ratio of
1:10.000 (14). According to Bianchi and Roccuzzo (15),
prevalence of primary teeth impaction is same with
Krough et al (14), 1:10.000. The least common impacted deciduous tooth is the first molar (16). In this case
report, maxillary first deciduous tooth is presented.
The impaction may be primary, refers to teeth that
have never erupted due to some etiologic factors as
stated above, or it may be reimpaction (secondary
impaction), in which, due to ankylosis, the teeth after eruption are re-implanted (9). As it is stated in literature (9), the impaction may be primary, meaning
the tooth has never erupted due to some reasons (as
known as primary failure of eruption) or it may be secondary impaction, in which the tooth after eruption
is reimpacted. To our knowledge, no case, involved in
impacted deciduous tooth with caries in dentigerous
cyst, has been reported in the literature. The presence
of caries on the crown indicates this tooth has previously erupted. Reimpaction of deciduous of a tooth
is a rare situation where it was in primary dentition.Also, Antoniades et al. (10) and Rasmussen et al. (9)
reported reimpaction of teeth cases.
Dentigerous cysts are the second most common
odontogenic cyst after radicular cyst. Dentigerous
cysts involve impacted, unerupted permanent teeth,
supernumerary teeth, odontomas and rarely deciduous teeth. They are generally asymptomatic, being
found on routine dental radiographic examination
(12,17). In this case, maxillary deciduous molar was
in dentigerous cyst, 1.5 cm diameter. Surgical removal was preferred as stated in literature (1).
According to literature, etiologic factors including
trauma, precocious eruption of the first permanent
molar, congenitally missing permanent teeth, defects
in the periodontal membrane, odontoma, and ankylosis may play role in the impaction of deciduous
molar (7,8). From all of the cited etiological factors,
ankylosis seems to be involved in the majority of cases and may explain why it has previously erupted.
Cildir et al. presented a case report which included
an eight and a half-year-old-child with a compound
odontoma located in the mandible, which caused the
impaction of both primary and permanent canines
(7). They surgically removed compound odontoma,
and permanent lateral was erupted spontaneously.
In this case, the preferable treatment option was
extraction because of embedded within dentigerous
cyst and caries. Also the germ of the impacted deciduous molar caused the maxillary right premolar into
a malposition.