Jung M
Policlinic for Operative and Preventive Dentistry, Justus-Liebig-University, Giessen, Germany.
Int Endod J. 2004 Mar;37(3):205-13. doi: 10.1111/j.0143-2885.2004.00778.x.
To describe the conservative endodontic treatment and the 1-year follow-up of a permanent maxillary lateral incisor with dens invaginatus.
Frequently, the root canal treatment of invaginated teeth is challenging because of problems associated with gaining access to the root canals and with variations of canal morphology associated with this type of malformation. The present case describes the complex root canal treatment of dens invaginatus in a maxillary lateral incisor with three root canals (Oehler type III), incomplete apex formation, necrotic pulp and abscess formation. After gaining access to two root canals and the invagination with the help of a dental operating-microscope, the canals and the invagination were instrumented and calcium hydroxide dressing was applied for 6 months. Apexification and osseous bone repair were achieved, and the canals were filled with gutta-percha. A follow-up after 1 year showed that the tooth was free of any clinical symptoms and the periapical condition was normal.
The present case demonstrated that conservative root canal treatment can be performed successfully even in sever cases of dens invaginatus. The use of a dental operating microscope can help in the management of complicated cases of invaginated teeth through conventional root canal treatment.
描述1例上颌恒侧切牙牙内陷的保守性牙髓治疗及1年随访情况。
通常，由于在进入根管以及与这种畸形相关的根管形态变异方面存在问题，牙内陷牙齿的根管治疗具有挑战性。本病例描述了1例上颌侧切牙牙内陷（Oehler III型，有3个根管）、根尖未完全形成、牙髓坏死并伴有脓肿形成的复杂根管治疗。在牙科手术显微镜的辅助下进入2个根管及牙内陷后，对根管及牙内陷进行预备，并应用氢氧化钙封药6个月。实现了根尖诱导成形及骨质修复，根管内充填牙胶尖。1年的随访显示该牙无任何临床症状，根尖周状况正常。
本病例表明，即使在牙内陷严重的病例中，保守性根管治疗也可成功实施。牙科手术显微镜的使用有助于通过传统根管治疗处理牙内陷的复杂病例。
