Iqbal Zahid, Qureshi Abdul Hakeem
Department of Operative Dentistry and Endodontics, College of Dentistry/Qassim University, Kingdom of Saudi Arabia.
Department of Operative Dentistry and Endodontics, College of Dentistry/Ziauddin University, Karachi.
J Coll Physicians Surg Pak. 2014 Nov;24 Suppl 3:S180-2.
A 48-year-old male patient presented to the Department of Endodontics for evaluation of right first permanent molar, which had received non-surgical root canal treatment two years ago and was restored with core material. The presenting symptoms included swelling in the buccal vestibule and pain overnight. Clinical examination demonstrated that the mandibular right first molar was sensitive to percussion and also showed fluctuant swelling in the vestibule proximal to the molar and mild mobility. Radiographic examination revealed a poor quality obturation of the mesial and distal root, distal root resorption, extensive periapical and furcation radiolucency and bone loss. A diagnosis of acute periapical abscess of the mandibular right first molar was made. Tooth was treated non-surgically by the manual application of MTA in the root canal. Follow-up evaluation was performed at one year after the treatment. Clinically, treatment was considered successful due to the absence of clinical signs, symptoms and radiographic appearance with substantial reduction (more than 50%) in the diameter of the periapical radiolucency. Mineral trioxide aggregate monoblock obturation technique appears to be a valid technique to obtain periradicular healing in re-treatment of previously root canal treated teeth with periapical lesion.
一名48岁男性患者因右下颌第一恒磨牙问题前往牙髓病科就诊。该患牙两年前接受过非手术根管治疗并使用核材料进行了修复。现出现的症状包括颊侧前庭肿胀和夜间疼痛。临床检查发现下颌右第一磨牙叩诊敏感，磨牙近前庭处有波动感肿胀且有轻度松动。影像学检查显示近中根和远中根充填质量差，远中根吸收，广泛的根尖周和根分叉透射区及骨质丧失。诊断为下颌右第一磨牙急性根尖周脓肿。通过手动将MTA应用于根管对患牙进行了非手术治疗。治疗后一年进行了随访评估。临床上，由于无临床体征、症状且影像学表现显示根尖透射区直径大幅缩小（超过50%），治疗被认为是成功的。矿物三氧化物凝聚体整体充填技术似乎是一种有效的技术，可使先前根管治疗且有根尖周病变的牙齿再治疗时获得根尖周愈合。
