Department of Pediatric Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
J Endod. 2009 Nov;35(11):1603-6. doi: 10.1016/j.joen.2009.07.019. Epub 2009 Sep 23.
Trauma to the teeth and supporting structures is a frequent problem among children. Endodontic treatment is necessary for 41.3% of traumatized teeth. Two of the most important criteria for successful endodontic treatment are the elimination of microorganisms and apical sealing. A combination of antibiotic drugs (metranidozole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. For cases in which apical sealing is difficult, specific materials to plug the apical region have been advocated. Mineral trioxide aggregate (MTA) has become the material of choice because it is biocompatible and has bacteriostatic action.
This case report describes the nonsurgical retreatment of a traumatized tooth that had already undergone unsuccessful apical resection associated with a large periradicular lesion. A combination of antibiotic drugs was used as an intracanal medicament, and MTA was used to obtain a hermetic seal of the lateral tooth that had undergone unsuccessful apical resection.
On follow up, the tooth was clinically and radiographically asymptomatic for 30 months.
The results of this case show that MTA and triple antibiotic paste can be used clinically in the treatment of an unsuccessfully resected tooth associated with a large periradicular lesion.
牙齿和支持结构的创伤是儿童中常见的问题。41.3%的外伤性牙齿需要进行牙髓治疗。牙髓成功治疗的两个最重要的标准是消除微生物和根尖密封。将抗生素药物(甲硝唑、环丙沙星和米诺环素)联合使用以消除目标细菌,这些细菌可能是牙髓病变的来源。对于根尖密封困难的情况,已经提倡使用特定的材料来堵塞根尖区域。由于具有生物相容性和抑菌作用,矿物三氧化物聚合体(MTA)已成为首选材料。
本病例报告描述了已行不成功的根尖切除术并伴有大根尖周病变的外伤性牙齿的非手术再治疗。将抗生素药物联合用作根管内药物,并用 MTA 获得未成功根尖切除的侧牙的密封。
随访 30 个月时,牙齿临床和影像学无症状。
该病例的结果表明,MTA 和三联抗生素糊剂可在临床上用于治疗与大根尖周病变相关的未成功切除的牙齿。