Kaya-Büyükbayram Işıl, Özalp Şerife, Aytugar Emre, Aydemir Seda
Acibadem Hospital Endodontics, Istanbul, Turkey.
Department of Pediatrics, Faculty of Dentistry, Bezmialem University, Istanbul, Turkey.
Case Rep Dent. 2014;2014:403045. doi: 10.1155/2014/403045. Epub 2014 Oct 30.
Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler's type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler's type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened.
牙内陷是一种发育异常，导致在矿化阶段之前，一个内衬牙釉质的腔隙侵入牙冠或牙根。本报告介绍了一名9岁女性患者患有奥勒（Oehler）III型牙内陷的坏死未成熟恒牙的再生牙髓治疗。借助锥形束计算机断层扫描（CBCT），确诊为牙内陷（奥勒III型）和一个大的根尖周病变。在本病例中，与经典的再血管化方案相反，进行了机械预备，显然这并未干扰再生过程。用手动K锉对陷入的根管进行机械预备后，用三联抗生素糊剂对陷入的根管腔进行消毒，随后诱导根尖周组织形成血凝块并放置三氧化矿物凝聚体。在1年的随访中，该牙临床无症状。影像学检查显示根尖周病变完全愈合。在20个月的随访中，影像学检查还显示开放的根尖已闭合，根管壁增厚。
