Akers Harry Francis, Henderson Carolyn Mary, Foley Michael Anthony
Brisbane Dental Hospital, Queensland Health, Brisbane, Queensland, Australia.
Aust Endod J. 2014 Apr;40(1):32-8. doi: 10.1111/aej.12056. Epub 2014 Jan 24.
This case report, involving an indigenous Australian, presents the diagnosis and non-surgical endodontic management of a 22 with developmental abnormalities. They include a dens evaginatus and a dens invaginatus that extends to an apical burst in a second truncated root. Cone-beam computed tomography and endodontic microscopy were not available to the clinician. This case report focuses on ambiguities appearing in the literature relating to classification and terminology associated with the abovementioned developmental anomalies. It also demonstrates the need to methodically collect and cautiously interpret available information before initiating endodontic intervention. Axial inclination, distance perception, internal demarcation and spatial awareness, together with an understanding of dental anatomy, embryology and histology and associated physiology and pathology, allowed the clinician to accurately predict the point, the angle and the depth of coronal access. Sensibility of the dentino-pulpal complex was maintained. Critical thinking, experience, innovation, problem-solving and established principles can compensate for inaccessible technologies.
本病例报告涉及一名澳大利亚原住民,介绍了一名22岁发育异常患者的诊断及非手术牙髓治疗情况。发育异常包括一个牙中牙和一个牙内陷,后者延伸至第二截断根的根尖孔处。临床医生无法获得锥形束计算机断层扫描和牙髓显微镜。本病例报告重点关注文献中与上述发育异常相关的分类和术语方面存在的模糊之处。它还表明在开始牙髓治疗干预之前,有必要系统地收集并谨慎解读现有信息。轴向倾斜、距离感知、内部界限和空间意识,以及对牙齿解剖学、胚胎学和组织学以及相关生理学和病理学的理解,使临床医生能够准确预测冠部开髓的点、角度和深度。牙髓复合体的敏感性得以维持。批判性思维、经验、创新、解决问题的能力以及既定原则可以弥补无法获取的技术。