Charakteristika von Milchzahnankylosen: Ergebnisse einer retrospektiven Analyse von Orthopantomogrammen

Zusammenfassung

Hintergrund

Milchzahnankylosen sind gekennzeichnet durch eine lokale Störung des parodontalen Ligaments, die zu einer pathologischen starren Verbindung zwischen der Zahnhartsubstanz und dem Alveolarknochen führt. Trotz intensiver Forschung ist die Ätiologie bisher unklar, wobei endogene Faktoren als Ursache zunehmend in den Vordergrund rücken. Das Ziel der vorliegenden retrospektiven Studie bestand darin, die Ausprägung von Milchzahnankylosen sowie deren dentale und alveoläre Konsequenzen anhand von Orthopantomogrammen zu analysieren und daraus Implikationen für therapeutische Interventionen abzuleiten.

Material und Methode

Im Rahmen der retrospektiven Datenerfassung wurden von 1841 Patienten, die zwischen den Jahren 2000 und 2023 in der Abteilung für Kieferorthopädie der Universitätsklinik Marburg behandelt wurden, 197 Patienten identifiziert, die mindestens einen Milchmolaren mit okklusalem Versatz aufwiesen. Die Orthopantomogramme dieser Kohorte wurden retrospektiv analysiert und ausgewertet.

Ergebnisse

Insgesamt wurden auf den Orthopantomogramme 636 Milchzahnankylosen erfasst. Es wurde überwiegend eine leichte bis mäßige Infraposition (34% bzw. 61%) festgestellt. Zudem wurde eine geringfügige Kippung der Nachbarzähne mit einem durchschnittlichen mesialen bzw. distalen Neigungswinkel von 6° festgestellt. Während der mesiale Neigungswinkel des Nachbarzahns bei zunehmender Infraposition konstant blieb, wurde eine deutliche Zunahme des distalen Neigungswinkels in Verbindung mit der Zunahme der Infraposition festgestellt. Über die Hälfte der Fälle wies eine geringe oder moderate Wurzelresorption auf (58% bzw. 54% mesiale/distale Wurzel), ein Drittel zeigte dagegen ausgeprägte Wurzelresorptionen (31% bzw. 32% mesiale/distale Wurzel). In 28% der Fälle wurde eine verringerte Alveolarkammhöhe im Vergleich zur kontralateral gesunden Seite festgestellt. In 21% der Fälle wurde ein atypischer Alveolarkammverlauf mit zunehmendem Alter diagnostiziert.

Schlussfolgerung

Die überwiegende Anzahl der Milchzahnankylosen wies einen geringen Schweregrad auf. Eine ausgeprägte Infraposition manifestierte sich selten, jedoch in Zusammenhang mit zunehmender Kippung der Nachbarzähne sowie einem negativen Einfluss auf das Alveolarknochenwachstum.

Abstract

Background

Infraocclusion of primary molars is characterized by local disturbance of the periodontal ligament, which leads to a pathological rigid connection between the tooth structure and the alveolar bone. Despite extensive research, the etiology of this condition remains unclear, with endogenous factors playing a prominent role in its development. The aim of this retrospective study was to analyze the manifestation of infraoccluded primary molars and its dental and alveolar consequences using panoramic radiographs and to derive implications for therapeutic interventions.

Materials and Methods

Of 1841 patients undergoing treatment in the Department of Orthodontics at Marburg University Hospital between 2000 and 2023, 197 patients with at least one infraoccluded primary molar were recorded using panoramic radiographs and analyzed retrospectively.

Results

A total of 636 infraoccluded primary molars were identified. Mild to moderate infraocclusion was predominantly found, with 34% and 61% respectively. Slight tipping of the adjacent teeth was also observed, with an average mesial and distal angle of 6°. While the mesial angle of the adjacent tooth remained constant with increasing infraocclusion, a significant increase in the distal angle was observed in association with increasing infraocclusion. Approximately half of the cases showed mild or moderate root resorption (58% and 54% mesial/distal root), while one third showed severe root resorption (31 and 32% mesial/distal root). In 28% of the cases, a reduced alveolar height was observed compared to the contralateral healthy side. An atypical alveolar ridge was diagnosed in 21% of cases with increasing age.

Conclusion

The majority of infraoccluded primary molars were of low severity. A pronounced infraocclusion manifested itself rarely, but in connection with increasing tilting of the neighbouring teeth and a negative influence on alveolar bone growth.

Schlüsselwörter

Milchzahnankylosen - Milchmolaren - Infraposition - Orthopantomogramm

Keywords

deciduous tooth ankylosis - primary molars - infraocclusion - panoramic radiograph

Publication History

Article published online:
12 June 2025

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