Jung Il-Young, Lee Seung-Jong, Hargreaves Kenneth M
Department of Conservative Dentistry, Yonsei University School of Dentistry, Seoul, Korea.
Tex Dent J. 2012 Jun;129(6):601-16.
This case series reports the outcomes of 8 patients (ages 9-4 years) who presented with 9 immature permanent teeth with pulpal necrosis and apical periodontitis. During treatment, 5 of the teeth were found to have at least some residual vital tissue remaining in the root canal systems. After NaOCI irrigation and medication with ciprofloxacin, metronidazole, and minocycline, these teeth were sealed with mineral trioxide aggregate and restored. The other group of 4 teeth had no evidence of any residual vital pulp tissue. This second group of teeth was treated with NaOCl irrigation and medicated with ciprofloxacin, metronidazole, and minocycline followed by a revascularization procedure adopted from the trauma literature (bleeding evoked to form an intracanal blood clot). In both groups of patients, there was evidence of satisfactory postoperative clinical outcomes (1-5 years); the patients were asymptomatic, no sinus tracts were evident, apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls, apical closure, or increased root length.
本病例系列报告了8例患者（年龄9至4岁）的治疗结果，这些患者共有9颗未成熟恒牙出现牙髓坏死和根尖周炎。治疗过程中，发现其中5颗牙齿的根管系统中至少残留有一些活髓组织。经次氯酸钠冲洗并用环丙沙星、甲硝唑和米诺环素药物处理后，这些牙齿用三氧化矿物凝聚体封闭并进行修复。另一组4颗牙齿未发现任何残留活髓组织的迹象。这组牙齿经次氯酸钠冲洗并用环丙沙星、甲硝唑和米诺环素药物处理后，采用从创伤文献中借鉴的血管再生程序（诱发出血以形成根管内血凝块）。两组患者均有术后临床效果良好的证据（随访1至5年）；患者无症状，无窦道，根尖周炎已消退，影像学证据显示牙本质壁持续增厚、根尖闭合或牙根长度增加。
