Pai Ar Vivekananda, Khosla Manak
Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences (Manipal University), Mangalore, India.
J Conserv Dent. 2012 Jul;15(3):298-302. doi: 10.4103/0972-0707.97966.
This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.
本病例报告阐述了在处理非牙周问题的手术过程中,在完成牙髓治疗之前进行预后判定及即刻切除术的情况。该病例显示上颌第二磨牙远中颊根因阻生第三磨牙的挤压导致外部压迫性吸收。尽管对第二磨牙进行了牙髓治疗,但未见愈合迹象,于是决定拔除第三磨牙。掀起 flap 并拔除第三磨牙后,由于吸收牙根周围严重的骨质流失,预后不良显而易见。但鉴于第二磨牙的战略价值,发现进行切除术是有益的。因此,在牙髓治疗完成之前,在同一手术区域进行了即刻切除术。这避免了日后另行手术切口并承受相关创伤来单独进行切除术的需要。切除术后完成牙髓治疗并制作全冠有助于挽救牙齿剩余的功能部分,并防止出现远中延伸及其潜在的弊端。 (注:原文中“flap”未明确中文释义,可能是“瓣”之类的医学术语,这里保留英文未翻译)