Institute of Stomatology, Nanjing Medical University, Nanjing, China.
Int J Oral Sci. 2012 Dec;4(4):231-4. doi: 10.1038/ijos.2012.62. Epub 2012 Dec 7.
This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.
本病例报告描述了使用锥形束 CT（CBCT）对上颌融合第二和第三磨牙的诊断和牙髓治疗。一名 31 岁的中国男性，无相关医学或家族/社会病史，右上颌磨牙区出现搏动性疼痛，此前曾试图拔牙但未成功。临床检查最初显示第二磨牙远颊侧颊面有一个大的额外牙尖受损。然而，CBCT 显示第三磨牙与第二磨牙融合。出乎意料的是，上颌左侧第三磨牙也与第二磨牙融合，并且未萌出的额外第四磨牙的牙冠可能也与第二磨牙的根尖区域融合。如果没有充分的影像学检查，不应进行手术操作。CBCT 可以精确定位右侧上颌融合磨牙的根管，从而成功进行牙髓治疗，6 个月后得到证实。
