| Abstract | Zub niče u usnu šupljinu nakon što se razvije polovina ili tri četvrtine njegova korijena. Međutim, razni lokalni, sistemski i genetski čimbenici te njihovo međudjelovanje mogu uzrokovati impakciju zuba. Najčešće su impaktirani zubi u gornjoj čeljusti treći molari,
zatim očnjaci, drugi pretkutnjaci i središnji sjekutići. S obzirom na to da je većinom asimptomatska, impakcija zuba uglavnom se kasno dijagnosticira. Dijagnoza se uspostavlja na temelju kliničkoga pregleda i radioloških snimki. Liječenje podrazumijeva
interdisciplinarni pristup koji uključuje opće stomatologe, specijaliste ortodoncije, kirurgije, a ponekad i parodontologije. Ovisno o dobi pacijenta i položaju impaktiranoga zuba, specijalisti ortodoncije i oralne kirurgije odlučuju se za interceptivni pristup liječenju, ortodontsku terapiju ili kirurško prikazivanje zuba. Ako se dijagnoza postavi dovoljno rano, moguće je interceptivno pristupiti liječenju. Ponekad to nije dovoljno, stoga je potrebno kirurški prikazati impaktiran zub. Ortodontsko-kirurška terapija
impaktiranih zubi podrazumijeva kirurško prikazivanje zuba, slijedi ortodontsko izvlačenje zuba, ispravljanje nagiba korijena i krune te poravnavanje zubi u zubnom luku. Tri su načina kirurškoga prikazivanja zubi: metoda zatvorene erupcije, metoda otvorene erupcije, apikalno pomaknuti režanj. Odabirom neprikladne metode kirurškoga prikaza ili djelovanjem neodgovarajućih ortodontskih sila mogu se javiti nepoželjni ishodi: gubitak kosti, gubitak zuba, resorpcija korijena, gingivna recesija, razlika u dužini kruna zubi. Impaktirani se zubi mogu uspješno liječiti individualnim i interdisciplinarnim pristupom, suradnjom općih stomatologa, ortodonta, kirurga i parodontologa, odabirom odgovarajuće terapije ovisno o dobi pacijenta i položaju zuba te prepoznavanjem potencijalnih komplikacija. |
| Abstract (english) | A tooth emerges into the oral cavity after developing a half or three-quarters of its root. However, various local, systemic, and genetic factors and their interactions can cause tooth impaction. The most frequently impacted teeth in the maxilla are the third molars, followed by canines, second premolars, and central incisors. Since impaction is mostly asymptomatic, it is generally diagnosed late. Diagnosis is established based on clinical examination and radiographic imaging. Treatment involves an interdisciplinary approach that includes general dentists, orthodontists, surgeons, and sometimes periodontists.
Depending on the patient's age and the position of the impacted tooth, orthodontists and surgeons choose an interceptive treatment approach, orthodontic therapy, or surgical exposure of the tooth. If the diagnosis is made at an early stage, an interceptive approach to treatment is possible. However, sometimes this is not sufficient, thus surgical exposure of the impacted tooth is necessary. Orthodontic-surgical therapy of impacted teeth involves surgical exposure of the tooth followed by orthodontic traction, correction of the root and crown inclination, and alignment of the teeth in the dental arch. There are three methods of surgical tooth exposure: closed eruption method, open eruption method, or apically repositioned flap. Choosing an inappropriate method of surgical exposure or applying inadequate orthodontic forces can result in undesirable outcomes such as bone loss, tooth loss, root resorption, gingival recession, or differences in the length of the tooth crowns. With an individualized and interdisciplinary approach, collaboration among general dentists, orthodontists, surgeons, and periodontists, an selecting appropriate therapy based on the patient's age and tooth position, as well as recognizing potential complications, impacted teeth can be successfully treated. |
