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病例报告:外伤致牙齿脱位后伴牙根外吸收及根端囊肿的上颌中切牙的根管治疗和外科治疗

Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion.

作者信息

Lux Hans-Christian, Goetz Falko, Hellwig Elmar

机构信息

University Hospital Freiburg, Operative Dentistry and Periodontology, Freiburg, Germany.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Nov;110(5):e61-7. doi: 10.1016/j.tripleo.2010.04.033. Epub 2010 Aug 9.

Abstract

In the age group between 6 and 12 years, trauma to the upper incisors happens frequently. In the case of avulsion, a replantation is the state-of-the-art treatment; however, it may lead to several complications, particularly if suitable posttraumatic management is not carried out. External cervical resorptions as well as apical granuloma and cysts due to microbial contamination of the root canal are common complications. In the presented trauma case, a conservative approach was chosen to treat a large cystic lesion combined with cervical and apical resorptions. After initial placement of Ledermix and calcium hydroxide into the root canal, a marsupialization with the temporary insertion of an obturator was performed. The gradual reduction led to a fast recovery of the bony defect and a root canal filling was placed. The 2-year follow-up showed an improved condition. All adjacent teeth remained vital during the course of the treatment.

摘要

在6至12岁的年龄组中,上颌切牙外伤较为常见。对于牙脱位的情况,再植是目前的最佳治疗方法;然而,这可能会导致多种并发症,尤其是在未进行适当的创伤后处理时。根管微生物污染导致的外吸收以及根尖肉芽肿和囊肿是常见的并发症。在本创伤病例中,选择了保守方法来治疗一个伴有颈部和根尖吸收的大囊性病变。在最初将利美松和氢氧化钙放入根管后,进行了袋形术并临时插入了封闭剂。逐渐缩小导致骨缺损快速恢复,并进行了根管充填。2年的随访显示病情有所改善。在治疗过程中,所有相邻牙齿均保持活力。

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