“阻生智齿”:修订间差异

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2017年5月27日 (六) 08:43的版本

阻生智齿
阻生智齿
CT三维成像显示未拔除的阻生智齿相邻于下牙槽神经英语inferior alveolar nerve
醫學專科牙醫學

阻生智齿 ( 阻生第三臼齿)是智齿受其他牙齿影响而未能完全牙萌出英语tooth eruption阻生齿英语Tooth impaction。阻生智齿可能会造成冠周炎英语pericoronitis或损坏相邻牙。通常考虑第三臼齿的萌出角度、牙根发育阶段、阻生深度、萌出可用空间以及第三臼齿的尺寸。[1]

智齿变为阻生的原因是牙尺寸与下颌尺寸不匹配。阻生智齿的分类按照阻生方向、相比较于邻牙咬合面的深度、覆盖在牙冠上的牙龈或牙槽骨的量。[2][3]也可按是否有临床症状分类。[4]通常在青春期后期邻牙出现阻生症状时才发现智齿问题。可用口腔全景发射线检查英语panoramic radiograph筛选。

阻生智齿感染可用抗生素、牙結石清除術(洗牙)、龈切除术英语gingivectomy做初步治疗。但通常不会奏效并发生其它并发症。最常用办法是拔除智齿。其风险与拔牙的难度成正比。如果有高风险的下牙槽神经英语inferior alveolar nerve,可能仅拔除智齿的牙冠,故意保留智齿的牙根,这称为智齿冠切术英语coronectomy。其风险是残留牙根的顽固性感染。

分类

File:Impacted wisdom teeth summary.ogv
视频:Impacted wisdom teeth

牙齿可分类为发育牙、萌出牙英语Tooth eruption、埋伏牙(不受其它牙影响但是无法萌出)、阻生牙英语Tooth impaction

智齿发育于14岁至25岁,16岁时已经有50%的牙根形成。25岁时有95%的人智齿全部萌出。但是智齿的移动在25岁以后仍会继续。[5]:140

临床统计结果,11%的阻生智齿发病并有临床症状,0.6%有症状但未发病,51%无症状但发病,37%无症状且未发病。[4]

阻生智齿按照其方向(最常见的是向前倾斜,称“近中”,阻生深度、是否感染发炎来描述。[5]:143–144 其中年龄是最相关于拔除智齿的难度与复杂度[6]而不是阻生方向.[7]

向后倾斜的阻生智齿(远中阻生)且牙冠后部慢性感染(绿色箭头)
不倾斜的阻生智齿(垂直阻生)
向前倾斜的阻生智齿(近中阻生)
水平阻生智齿

征兆与症状

冠周炎英语pericoronitis(绿色箭头)

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