Mogućnosti kirurško-ortodontskog liječenja impaktiranih zuba

master's thesis

• Title (english): Possibilities of surgical-orthodontic treatment of impacted teeth
• Author: Laura Centner
• Mentor: Davor Brajdić (mentor)
• Committee member: Davor Brajdić (predsjednik povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Committee member: Samir Čimić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2020-09-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Najčešće impaktirani zubi su donji treći kutnjaci, slijede gornji očnjaci, od kojih su dvije
trećine smještene palatinalno, zatim donji drugi pretkutnjaci te gornji središnji sjekutići. Vrlo
je važno rano postaviti točnu dijagnozu kliničkim pregledom i radiološkom dijagnostikom. Za
određivanje položaja impaktiranog zuba u sve tri dimenzije preporučuje se korištenje CBCTa. Primjenom interceptivne terapije može se spriječiti nastanak impaktiranosti i omogućiti
spontano nicanje zuba. Ako interceptivnu terapiju nije moguće provesti ili je ona
neučinkovita, terapijski izbori su kirurško-ortodontsko liječenje, autotransplantacija ili
ekstrakcija impaktiranog zuba. Kirurško-ortodontsko liječenje započinje ortodontskim
stvaranjem prostora za smještaj impaktiranog zuba u zubni luk, ako je to potrebno. Zatim
slijedi kirurški zahvat prikazivanja krune impaktiranog zuba i naposljetku ortodontsko
izvlačenje i smještanje impaktiranog zuba u pravilan položaj. Postoje četiri glavne metode
kirurškog prikaza impaktiranih zuba, a to su: gingivektomija, apikalno pomaknuti režanj,
metoda zatvorene erupcije i predortodontsko kirurško prikazivanje zuba. Položaj
impaktiranog zuba glavni je čimbenik o kojemu ovisi odabir prikladne metode kirurškog
prikaza, a još neki čimbenici su dob pacijenta i prisutnost dovoljno pričvrsne gingive. U
liječenju impaktiranih zuba moguć je nastanak brojnih komplikacija, a one se mogu izbjeći
pravilno i rano postavljenom dijagnozom te primjenom odgovarajućeg kirurškog zahvata i
ortodontske biomehanike. Za uspjeh kirurško-ortodontske terapije, koja osigurava optimalnu
estetiku i funkciju, presudni su individualni i interdisciplinarni pristup i rana dijagnostika.

Abstract (english)

The most frequently impacted teeth are the lower third molars, followed by the upper canines,
the two-thirds of which are positioned pallatinaly, then the lower second premolars, and the
upper central incisors. It is very important that the right diagnosis is established early by a
clinical examination and a radiological diagnostics. Also, it is recommended to utilize CBCT
for determining the position of the impacted tooth in all three dimensions. The usage of the
interceptive therapy makes it possible to prevent the occurrence of impaction and allow a
spontaneous tooth eruption. If interceptive therapy can't be conducted or if it is not effective,
the possible therapy choices are surgical-orthodontic treatment, autotransplantation, or
extraction of the impacted tooth. Surgical-orthodontic treatment begins with an orthodontic
space-making in order to position the impacted tooth in the dental arch if necessary, followed
by the surgical procedure of exposing the crown of the impacted tooth, and ultimately by the
orthodontic traction and the placement of the impacted tooth in the correct position. There are
four main techniques of surgical exposure of the impacted teeth: gingivectomy, apically
positioned flap, closed eruption technique, and pre-orthodontic surgical teeth exposure. The
position of the impacted tooth is the main factor which influences the choice of the appropriate surgical exposure technique. Additionally, there are also other factors such as the
age of the patient and the presence of the sufficiently attached gingiva. Although numerous complications can occur while treating the impacted teeth, they can be avoided by
establishing an accurate and early diagnosis and by using the suitable surgical procedure and
orthodontic biomechanics. For a successful surgical-orthodontic therapy which ensures
optimal aesthetics and function, it is crucial to use both individual and interdisciplinary
approaches and to establish diagnostics early.

• Keywords: oralnokirurški postupci; ortodoncija; uklješteni zub
• Keywords (english): Oral Surgical Procedures; Orthodontics; Tooth; Impacted
• Language: croatian
• URN:NBN: urn:nbn:hr:127:342714
• 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: 2021-01-22 16:10:36