Robazza Carlos Roberto Colombo, Alves e Motta Julio Cesar, de Carli Marina Lara, de Oliveira Pedreira Fernanda Rafaelly, Hanemann Joao Adolfo Costa
Professor, Department of Clinics and Surgery, Alfenas Federal University, Minas Gerais, Brazil.
J Contemp Dent Pract. 2013 May 1;14(3):556-9. doi: 10.5005/jp-journals-10024-1362.
This work describes the retreatment of an unusual case of dens invaginatus with gutta-percha overfilling at the gingival mucosa and chronic apical periodontitis in a 34-year-old woman. Initial periapical radiograph showed the presence of type II dens invaginatus with poor quality obturation, root perforation and chronic apical periodontitis of tooth 22.
Dens invaginatus is a tooth malformation caused by infolding of the dental papilla during tooth development. This anomaly has been associated with increased prevalence of pulpal and periapical diseases.
Conventional endodontic retreatment was performed using rotary files and calcium hydroxide paste as intracanal dressing. After 7 days, root canal was filled with guttapercha points and Sealapex® sealer. Obturation was radiographically followed and, after 3 years, absence of fistula and periapical radiolucency was observed, thus conventional endodontic therapy proved to be successful.
Conventional endodontic retreatment of type II dens invaginatus has been successful for a 3-year period, showing a better treatment alternative.
Conservative endodontic retreatment of dens invaginatus should be considered to promote periapical healing with complete reconstitution of bone and periodontal ligament regeneration without signs of recurrence over a period of 3 years. Moreover, it preserves the entire tooth.
本文描述了一名34岁女性Ⅱ型牙内陷病例的再治疗情况，该病例存在龈黏膜处牙胶超充及慢性根尖周炎。最初的根尖片显示22号牙为Ⅱ型牙内陷，根管充填质量差、根管穿孔及慢性根尖周炎。
牙内陷是牙齿发育期间牙乳头内卷引起的牙齿畸形。这种异常与牙髓病和根尖周病的患病率增加有关。
采用旋转锉和氢氧化钙糊剂作为根管内封药进行常规根管再治疗。7天后，用牙胶尖和Sealapex®封闭剂充填根管。通过影像学观察充填情况，3年后未见瘘管及根尖透射影，因此常规根管治疗被证明是成功的。
Ⅱ型牙内陷的常规根管再治疗在3年内取得了成功，是一种较好的治疗选择。
应考虑对牙内陷进行保守的根管再治疗，以促进根尖周愈合，实现骨和牙周膜的完全重建，且在3年内无复发迹象。此外，还能保留整个牙齿。
