Kumar Harleen, Al-Ali Muna, Parashos Peter, Manton David J
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
J Endod. 2014 May;40(5):725-31. doi: 10.1016/j.joen.2013.10.030. Epub 2013 Dec 15.
This review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis.
An infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia.
Periapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal.
This case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement.
本综述及病例报告介绍了一名10岁男孩的治疗情况，其双侧上颌恒侧切牙均表现为奥勒斯II型牙内陷并伴有牙髓受累。治疗因牙科焦虑、室上性心动过速、牙齿发育不成熟和面部蜂窝织炎而变得复杂。
对上颌左侧恒侧切牙感染坏死的牙髓进行根尖诱导成形术，并使用三氧化矿物凝聚体进行根管治疗。上颌右侧恒侧切牙坏死的牙髓在全身麻醉下进行根管清创和换药。
两颗牙齿均实现根尖愈合，右侧侧切牙显示牙根持续生长、牙本质根壁增厚且根尖形成完成。该牙齿对牙髓测试反应正常。初始治疗28个月后，右侧侧切牙根管出现进行性硬化。
本病例表明，对上颌右侧感染的牙内陷且根尖未成熟的侧切牙进行最小限度的根管清创后，可能实现牙髓再生。
