Abstract：
The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a orthodontic mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients.
摘要：
本文的目的是报告一名5岁儿童患有多种牙齿异常的临床病例和4年随访，强调早期诊断和使用联合儿科手术和正畸方法的重要性。一个五岁的男孩,在他母亲的陪同下,寻求龋齿和牙齿疼痛的牙科护理。临床和影像学检查显示龋齿活跃，下颌右第二前磨牙区域的一个多余的乳牙，原发性下颌右第二磨牙严重强直。治疗计划包括拔除多余的牙齿以及切开和拔除坚固的磨牙。当病人6岁时，永久性下颌右第一磨牙显示出喷发过程改变的迹象，并开始正畸治疗。将带有螺旋弹簧的单侧带环空间保持器放置在第一磨牙上，该螺旋弹簧旨在移动第一磨牙。一张新的全景射线照片，患者7岁时获得，提示上颌右犬的顶端区域存在牙瘤。手术切除和病变的组织病理学检查证实这是一个正在发展的牙瘤。手术后,由于咬合异常，包括上颌横向缺损，深覆盖,和中线偏差，患者接受了Haas型矫治器的快速上颌扩张治疗.当病人8岁时，正畸治疗继续使用可移动的Hawley扩张器和正畸下颌舌弓。目前,在9岁的时候，在手术暴露受影响的永久性上颌右犬并结合正畸附件以进行牵引后，该儿童仍在接受固定正畸治疗。采用多学科方法管理牙齿异常可促进良好的预后，并确保对年轻患者进行全面治疗。
