Clinic of Dentistry - Endodontics, University of Bergen, Norway.
Int Endod J. 2010 Jan;43(1):76-83. doi: 10.1111/j.1365-2591.2009.01645.x.
To present a case where a traumatized, immature tooth still showed capacity for continued root development and apexogenesis after root canal treatment was initiated based on an inaccurate pulpal diagnosis.
Traumatic dental injuries may result in endodontic complications. Treatment strategies for traumatized, immature teeth should aim at preserving pulp vitality to ensure further root development and tooth maturation. A 9-year-old boy, who had suffered a concussion injury to the maxillary anterior teeth, was referred after endodontic treatment was initiated in tooth 21 one week earlier. The tooth had incomplete root length, thin dentinal walls and a wide open apex. The pulp chamber had been accessed, and the pulp canal instrumented to size 100. According to the referral, bleeding from the root made it difficult to fill the root canal with calcium hydroxide. No radiographic signs of apical breakdown were recorded. Based on radiographic and clinical findings, a conservative treatment approach was followed to allow continued root development. Follow-up with radiographic examination every 3rd month was performed for 15 months. Continued root formation with apical closure was recorded. In the cervical area, a hard tissue barrier developed, which was sealed with white mineral trioxide aggregate (MTA). Bonded composite was used to seal the access cavity. At the final 2 years follow-up, the tooth showed further root development and was free from symptoms.
介绍一个病例，在根管治疗开始时基于不准确的牙髓诊断，受伤未成熟的牙齿仍显示出继续牙根发育和根尖形成的能力。
牙外伤可导致牙髓并发症。对于受伤未成熟的牙齿，治疗策略应旨在保持牙髓活力，以确保进一步的牙根发育和牙齿成熟。一名 9 岁男孩上颌前牙因脑震荡受伤，一周前在 21 号牙行根管治疗后被转诊。该牙牙根不完全，牙本质壁薄，根尖开口大。牙髓腔已暴露，牙髓管器械扩至 100 号。根据转诊记录，由于根管出血，难以用氢氧化钙填充根管。未记录到根尖破裂的放射学迹象。根据放射学和临床发现，采用保守治疗方法，以允许继续牙根发育。进行了 15 个月的每 3 个月一次的放射随访检查，记录到根尖闭合的持续牙根形成。在颈部区域，形成了一个硬组织屏障，用白色矿物三氧化物聚合体（MTA）密封。用粘结复合树脂封闭了进入腔。在最终的 2 年随访中，牙齿显示出进一步的牙根发育，且无症状。
