Različiti aspekti dva terapijska pristupa kod pacijenata sa hipodoncijom gornjih lateralnih sekutića
Sažetak
Uvod. Terapija hipodoncije gornjih lateralnih sekutića može biti ortodontska ili kombinovana, uključujući ortodontsku, hiruršku i protetsku terapiju. Oba terapijska pristupa imaju svoje prednosti i nedostatke i mogu biti veoma zahtevni za terapeuta, naročito kod odraslih pacijenata sa jednostranim nedostatkom gornjeg lateralnog sekutića. Prikazana su dva različita terapijska pristupa kod mladih odraslih osoba sa jednostranim nedostatkom gornjeg lateralnog sekutića. Prikaz bolesnika. Prvi slučaj predstavlja kombinovanu ortodontsko-hirurško-protetsku terapiju kod mlade odrasle osobe ženskog pola, starosti 22 godine, kod koje je kliničkim pregledom ustanovljen nedostatak zuba 12 sa potpuno zatvorenim prostorom, pomerenom sredinom gornjeg zubnog niza, smanjenim incizalnim razmakom i preklopom, interkuspidacijom molara III klase sa desne strane i I klase sa leve strane, V oblika gornjeg niza, uz postojanje tendencije ka obrnutom preklopu sekutića. Na osnovu skeletnog odnosa III klase i intraoralnog nalaza, odlučeno je da se otvori
prostor za zub 12 i koriguje incizalni razmak i preklop uz uspostavljanje okluzije I klase. Nakon ortodontske pripreme, postavljen je implant u zoni zuba 12 sa krunicom nakon završene faze hirurškog zarastanja. U drugom slučaju opisan je ortodontski tretman kod mlade odrasle ženske osobe, starosti 24 godine, sa jednostranom hipodoncijom lateralnog sekutića. Kliničkim i radiografskim pregledom ustanovljen je nedostatak zuba 12, sa mikrodontnim koničnim zubom 22, izraženom teskobom u donjem zubnom nizu, interkuspidacijom molara I klase sa desne strane i polu-II klase sa leve strane. Ortodontskom terapijom, uz ekstrakciju zuba 22, 35 i 44, korigovana je postojeća malokluzija, uz mezijalno pomeranje gornjih očnjaka na mesto lateralnih sekutića. Zaključak. Primenom oba terapijska pristupa, postignuti su zadovoljavajući estetski i funkcionalni rezultati i uspešno je korigovana malokluzija. Odluka o terapijskom pristupu treba da bude individualna, zasnovana na uzrastu, malokluziji, obliku i veličini očnjaka kao i željama samog pacijenta.
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