Shadmehr Elham, Kiaani Sima, Mahdavian Parinaz
Dental Materials Research Center and Departement of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Torabinejad Dental Research Center and Department of Periodontology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Dent Res J (Isfahan). 2015 Mar-Apr;12(2):187-91.
Dens invaginatus is a rare developmental anomaly of teeth with complex root canal system morphology. The present case describes a peg shape maxillary lateral incisor with dens invaginatus (Oehlers type II), necrotic pulp, and an associated large periradicular lesion. Nonsurgical endodontic treatment was performed with the aim of removing the blind sac with diamond bur under the use of operating surgical microscope. The root canal system was obturated with thermoplastic technique. Final restoration was done using composite. The 20-months clinical and radiological follow up revealed an asymptomatic tooth with healing of the periapical pathology; however, for complete healed periradicular lesion more follow up is needed. This case illustrated that a dens invaginatus malformed teeth with a large periradicular lesion can be managed successfully with nonsurgical root canal therapy (NSRCT).
牙中牙是一种罕见的牙齿发育异常，根管系统形态复杂。本病例描述了一颗呈钉状的上颌侧切牙伴牙中牙（奥勒斯II型）、牙髓坏死及相关的大根尖周病变。采用手术显微镜辅助，用金刚砂车针去除盲管，进行了非手术根管治疗。采用热塑技术充填根管系统。最终用复合树脂进行修复。20个月的临床和影像学随访显示患牙无症状，根尖周病变愈合；然而，为使根尖周病变完全愈合，还需要更多的随访。该病例表明，伴有大根尖周病变的牙中牙畸形牙可通过非手术根管治疗（NSRCT）成功治疗。
