Department of Orthodontics, Changzhou Stomatological Hospital, Changzhou, China.
Department of Orthodontics, Institute of Stomatology, Nanjing Medical University, Nanjing, China.
Int Endod J. 2016 Apr;49(4):402-9. doi: 10.1111/iej.12459. Epub 2015 May 9.
To highlight the reversal of signs suggesting pulpal necrosis following removal of a mini-implant without endodontic intervention.
A 23-year-old woman presented with a class III malocclusion, with crowded and malformed teeth and excessive gingival display. During orthodontic treatment, a Tomas orthodontic miniscrew was placed between the root apices of the maxillary central incisors. This was carried out by an orthodontic specialist who had treated more than 700 patients (with more than 2000 mini-implants) over the past 9 years. After 2 weeks of treatment, the right maxillary central incisor discoloured and did not respond to electrical pulp tests (EPT) but was sensitive to endo-ice. The miniscrew was removed under local anaesthesia. Teeth 11 and 21 were fixed with ligation wire, and glass-ionomer cement (GIC) was added to the occlusal surfaces of the first and second maxillary molars to heighten the occlusion and disclude the maxillary anterior teeth. After 4 months, the colour and pulp reactions to EPT and endo-ice of tooth 11 returned to normal. Because the use of a miniscrew had appeared to damage the pulp, subsequent a conservative orthodontic treatment using, traditional 'J' hooks was used and achieved satisfactory results. After 23 months of orthodontic treatment, the treatment was complete and a 15-month follow-up showed a successful outcome.
强调在不进行根管干预的情况下移除微型种植体后，提示牙髓坏死的迹象逆转。
一名 23 岁女性因 III 类错颌畸形、拥挤和畸形牙齿以及过度牙龈外露就诊。在正畸治疗过程中，在上颌中切牙根尖之间放置了 Tomas 正畸微型植入体。这是由一位正畸专家完成的，他在过去 9 年中治疗了超过 700 名患者（超过 2000 个微型植入体）。治疗 2 周后，右侧上颌中切牙变色，对电牙髓测试（EPT）无反应，但对endo-ice 敏感。在局部麻醉下移除微型植入体。用结扎丝固定 11 号和 21 号牙，并在第一和第二上颌磨牙的咬合面上添加玻璃离子体水泥（GIC），以增加咬合并遮挡上颌前牙。4 个月后，11 号牙的颜色和对 EPT 和 endo-ice 的牙髓反应恢复正常。由于微型植入体的使用似乎对牙髓造成了损伤，因此随后使用了传统的“J”钩进行了保守的正畸治疗，取得了满意的效果。正畸治疗 23 个月后，治疗完成，15 个月的随访显示治疗成功。
