Fernandes Marina
Goa Dental College and Hospital, India.
Iran Endod J. 2010 Fall;5(4):179-82. Epub 2010 Nov 15.
Persistent microorganisms in the root canal are known to cause endodontic treatments failure. Overextended gutta-percha can also act as a periradicular tissue irritant, leading to large periapical lesions. Retrieval of overextended gutta-percha with a nonsurgical approach can prove to be a challenge. This case describes the nonsurgical management of a large periapical lesion associated with overextended gutta-percha. Retrieval of gutta-percha was attempted but the overextended portion could not be removed. Aspiration of the purulent exudate was done through the root canal followed by use of a triple antibiotic paste. After 2 weeks the antibiotic paste was replaced with calcium hydroxide, to enhance the osseous regeneration. The periapical lesion showed a considerable amount of periapical healing after 15 months. The results of this case demonstrate that aspiration in conjunction with the triple antibiotic paste and calcium hydroxide may possibly be used in managing large periapical lesions associated with overextend gutta-percha.
根管内持续存在的微生物会导致牙髓治疗失败。超充的牙胶尖也可作为根尖周组织刺激物，导致较大的根尖周病变。采用非手术方法取出超充的牙胶尖可能具有挑战性。本病例描述了与超充牙胶尖相关的较大根尖周病变的非手术治疗。尝试取出牙胶尖，但超充部分无法去除。通过根管抽吸脓性渗出物，随后使用三联抗生素糊剂。2周后，将抗生素糊剂替换为氢氧化钙，以促进骨再生。15个月后，根尖周病变显示出大量根尖周愈合。本病例结果表明，抽吸联合三联抗生素糊剂和氢氧化钙可能可用于治疗与超充牙胶尖相关的较大根尖周病变。
