ABSTRACT
Objective:To report a case of germinated teeth of the left mandibular second molar diagnosed by cone-beam CT (CBCT), and to investigate its differential diagnosis, pathogenesis, and the application value of CBCT in the diagnosis of oral and maxillofacial diseases.Methods:One case of germinated teeth of the left mandibular second molar diagnosed according to oral general examination ad CBCT findings in Zhenjiang Stomatological Hospital, China in March, 2019 was included in this study. The characteristics and differential points of supernumerary cusp, fused teeth, geminated teeth and concresence of teeth were analyzed based on literatures.Results:CBCT examination showed that the number of mandibular dentition teeth was normal, there was a large area of low-density transmission area around the root of the left mandibular second molar. Three-dimensional reconstruction results revealed that the suspected supernumerary teeth were fused with the root of the left mandibular second molar. Sagittal projections showed that the suspected supernumerary teeth were located in the buccal side of the left mandibular second molar. Axial projections showed three separate root canal orifices at the level of pulp chamber floor, and the dentin of the two was connected. The suspected supernumerary teeth had an independent pulp cavity and a clear root canal, and fused with the distal root canal of the left mandibular second molar in the middle of the root to form a root canal. A "Y"-shaped structure was displayed on the sagittal projections. CBCT showed that the left mandibular second molar was a fused root. Based on oral clinical examination, the left mandibular second molar was confirmed to be a germinated tooth.Conclusion:CBCT is one of the most important means of oral auxiliary examination. It has significant advantages in the diagnosis of tooth abnormalities. It can help clinicians to make correct diagnosis and choose the appropriate treatment scheme. It has certain clinical significance and innovation.
ABSTRACT
Introduction : Le but de la présente étude est d'évaluer le taux de succès et les facteurs affectant le pronostic de l'auto-transplantation immédiate de la troisième molaire mandibulaire, au site de la première ou la deuxième molaire homolatérale après un suivi clinique et radiologique sur une période de trois ans. Matériel et méthodes : Un total de 90 troisièmes molaires mandibulaires ont été immédiatement transplantées pour remplacer la première ou la deuxième molaire homolatérale jugées non restaurables. Le stade de développement des molaires auto-transplantées varie de 3 à 7 selon la classification de Moorrees. Pour les molaires matures, le traitement canalaire est réalisé 1 à 2 semaines plus tard. A l'issue des contrôles cliniques et radiographiques des troisièmes molaires transplantées échelonnés selon un calendrier prédéfini, des statistiques descriptives ainsi que l'analyse du taux de réussite et des facteurs affectant le pronostic ont été réalisées. Résultats : L'âge moyen des patients était de 22,80 ans. Le taux de succès est de 87,8%. Le taux de réussite de l'auto-transplantation des troisièmes molaires immatures et matures est respectivement de 91,2% et de 81,8%. Le taux d'échec est de 12,2%.Le temps extra-alvéolaire apparait comme la cause principale des complications. Parmi les 11 transplantations considérées comme un échec, la résorption radiculaire externe est la manifestation principale représentée par 8 cas, suivi de 2cas d'ankylose et d'un cas d'expulsion du transplant. Conclusion : L'auto-transplantation immédiate des troisièmes molaires mandibulaires au site de la première ou de la deuxième molaire homolatérale est une solution viable et une alternative à la réhabilitation prothétique conventionnelle ou au traitement implantaire d'un point de vue thérapeutique et économique.
Introduction: The aim of the present study was to evaluate the success rate and to the factors affecting the prognosis of the immediate auto-transplantation of the mandibular third molar, in homolateral first or second molar site after clinical and radiological follow-up over a period of three years. Material and methods: A total of 90 mandibular third molars were immediately autotransplanted to replace homolateral lost first or second molar. The development stage of autotransplanted molars varied from 3 to 7 according to Moorrees. Root canal treatment began for mature molars 1 to 2 weeks later. Clinical and radiographic checkup of the transplanted third molars were done according to predesigned record form. Descriptive statistics and statistical analysis about success rate and to the factors affecting the prognosis were performed. Results: The mean age of treated patients was 22.80 years. The success rate was 87.8%. The success rates of the auto-transplantation of third immature and mature molars were 91.2% and 81.8%, respectively. The failure rate is 12.2% and extra-alveolar time appears as the main cause of complications. In all, 11 transplants were considered a failure. External radicular resorption appeared to be the principal manifestation with 8 cases, followed by 2 cases of ankylosis and 1 of transplant expulsion. Conclusion: Immediate auto-transplantation of the mandibular third molar teeth in homolateral first or second molar site is an interesting treatment alternative to conventional prosthetic rehabilitation or implant treatment in cases of lost molars from both a therapeutic and an economic point of view.