Interdisciplinarna suradnja kod terapije impaktiranih zuba

master's thesis

• Title (english): Interdisciplinary treatment of impacted teeth
• Author: Maja Zečević Čulina
• Mentor: Sandra Anić Milošević (mentor)
• Committee member: Sandra Anić Milošević (predsjednik povjerenstva)
• Committee member: Martina Šlaj (član povjerenstva)
• Committee member: Tomislav Katanec (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2023-06-28, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Orthodontics

Abstract

U normalnim uvjetima zub eruptira kada se razvije 1/2-3/4 njegove konačne duljine korijena. Impakcija zuba u većini se slučajeva dijagnosticira nakon toga razdoblja i općenito je bez simptoma te iz toga razloga pacijenti ulaze u terapiju kasnije od optimalnog. Impakcija zuba čest je problem u svakodnevnoj ortodontskoj praksi i u većini slučajeva prepoznaje se slučajno tijekom rutinskog kliničkog pregleda i analize radiološke snimke. Najčešće impaktirani zubi su mandibularni treći kutnjaci, zatim maksilarni očnjaci, mandibularni drugi pretkutnjaci i maksilarni središnji sjekutići. Ukoliko se dijagnoza impaktiranosti postavi dovoljno rano, moguće je postići prirodno nicanje zuba primjenom interceptivne terapije, odnosno pravodobnom ekstrakcijom mliječnog prethodnika. U slučajevima kada to nije moguće postići, liječenje impaktiranih zuba zahtijeva interdisciplinarnu suradnju ortodonta, oralnog kirurga, a ponekad i parodontologa. Terapija se temelji na kirurškoj ekspoziciji impaktiranog zuba jednom od metoda kirurškog prikaza i ortodontskim pomacima kako bi se impaktirani zub doveo u zubni luk. Na početku terapije potrebno je ortodontski osigurati dovoljno mjesta u zubnom luku za smještaj impaktiranog zuba. Zatim slijedi odabir prikladne metode kirurškog prikaza koji ovisi o položaju impaktiranog zuba, a vrlo je važno procijeniti postoji li dovoljno pričvrsne gingive kako bi se izbjeglo uključivanje parodontologa u proces terapije. Ukoliko, uslijed kompliciranosti slučaja, nijedna tehnika kirurške ekspozicije nije zadovoljavajuća, može se izvesti autotransplantacija ili pristupiti vađenju zuba. Ako situacija dozvoljava izvođenje jedne od metoda kirurškog prikaza, nakon razdoblja cijeljenja započinje se ortodontsko izvlačenje i smještanje zuba u pravilni položaj u zubnom luku. Liječenje je dugotrajno, komplicirano i izazovno, a uspješnost terapije ovisi o mnogobrojnim faktorima.

Abstract (english)

Under normal conditions, a tooth erupts when approximately half to three-quarters of its final root length has developed. Tooth impaction is typically diagnosed after this period and is generally asymptomatic, which is why patients often seek treatment later than optimal. Tooth impaction is a common problem in everyday orthodontic practice and is usually identified incidentally during routine clinical examinations and radiographic analysis. The most commonly impacted teeth are mandibular third molars, followed by maxillary canines, mandibular second premolars, and maxillary central incisors. If the diagnosis of impaction is made early enough, natural tooth eruption can be achieved through interceptive treatment, such as timely extraction of the primary predecessor. Otherwise, the treatment of impacted teeth requires interdisciplinary collaboration between an orthodontist, an oral surgeon, and sometimes a periodontist. Treatment involves surgically exposing the impacted tooth using appropriate techniques and aligning it within the dental arch through orthodontic movements. Sufficient space must be created within the arch initially, and the choice of surgical exposure technique depends on the tooth's position and the presence of adequate attached gingiva. If, due to the complexity of the case, none of the surgical exposure techniques are satisfactory, autotransplantation can be performed, or extraction of the tooth may be considered. If the situation allows for one of the tooth exposure methods to be performed, orthodontic traction begins after a healing period, which involves positioning the tooth correctly within the dental arch. The treatment is lengthy, complicated, challenging, and the success of the therapy depends on many factors.

• Keywords: impaktirani zub; metode kirurškog prikaza; ortodontsko izvlačenje
• Keywords (english): tooth impacted; surgical exposure techniques; orthodontic traction; oral surgical procedures; orthodontic extrusion
• Language: croatian
• URN:NBN: urn:nbn:hr:127:723202
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-06-15 09:16:16