Nawal Ruchika Roongta, Sehgal Ritu, Ansari Irfan, Talwar Sangeeta, Sood Abhinav, Verma Mahesh
Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Nov;108(5):e82-8. doi: 10.1016/j.tripleo.2009.06.015. Epub 2009 Sep 5.
A 37-year-old man reported to our department with the history of gunshot injury to the mandible 15 years before. His anterior mandible had been resected earlier and bone graft was seen. Intraoral examination of lower jaw revealed 4 remaining mandibular molars. These teeth were severely rotated such that they lay horizontal with respect to the mandibular base. Preoperative Dentascan spiral computerized tomography (CT) of the patient revealed obliteration of the mesial canals of the mandibular right first molar and pear-shaped internal resorption defect in the distal canal of the same tooth. This paper reports the challenging endodontic management of a rare case of severely angulated teeth also exhibiting traumatic sequelae in both roots of the impact tooth. It also highlights the usefulness of spiral CT scan in diagnosis of traumatic sequelae such as pulp canal obliteration and internal resorption.
一名37岁男性前来我科就诊，其有15年前下颌骨枪伤史。他的下颌前部此前已行切除并可见骨移植。下颌的口腔内检查发现剩余4颗下颌磨牙。这些牙齿严重扭转，相对于下颌骨基部呈水平位。患者术前的牙科螺旋计算机断层扫描（CT）显示下颌右第一磨牙近中根管闭塞，同一颗牙齿远中根管呈梨形内吸收缺损。本文报道了一例罕见的严重成角牙齿同时伴有患牙双根创伤后遗症的具有挑战性的根管治疗病例。它还强调了螺旋CT扫描在诊断诸如牙髓腔闭塞和内吸收等创伤后遗症方面的有用性。
