Yao L, Xu X, Ren M, Liu D, Ni Z, Lin F
Attending Physician, Pedodontic Department, School and Hospital of Stomatology, Wenzhou Medical University, China.
Attending Physician, Oral and Maxillofacial Surgery Department, School and Hospital of Stomatology, Wenzhou Medical University, China.
Eur J Paediatr Dent. 2015 Sep;16(3):201-4.
Inflammatory dentigerous cysts usually occur in the mixed dentition. It has been reported that inflammatory lesions from the root area of a deciduous tooth bring about the development of dentigerous cysts around the unerupted permanent tooth bud. Endodontic treatment is a common and successful procedure for periapical inflammation in children. An inflammatory dentigerous cyst can occur in conjunction with endodontically treated primary tooth.
This article reports a case of 6 years and 6 months old boy, with a single, well-defined, unilocular, radiolucent area enclosing the first right unerupted mandibular premolar, accidentally discovered on the panoramic radiograph. The first right primary molar had received a root canal treatment 18 months prior. Clinical findings combined with radiographic and microscopic examinations confirmed the diagnosis of inflammatory dentigerous cyst. As treatment, enucleation of the cyst with removal of the involved permanent tooth was chosen and a removable partial denture was supplied to the patient after surgery. The 5-year follow-up revealed good healing of the bony lesion and displaced teeth.
This case presented a severe and rare complication of endodontically treated primary tooth, and the recommendation includes: (1) early diagnosis of dentigerous cysts, which is essential to prevent extensive treatment; (2) more information on the adverse side effects of an endodontic treatment should be given to patients and parents; (3) patients should be informed about the importance of follow-ups and radiographic follow-up should be routinised.
炎性含牙囊肿通常发生于混合牙列期。据报道，乳牙牙根部位的炎性病变可导致未萌出恒牙牙胚周围含牙囊肿的形成。根管治疗是治疗儿童根尖周炎常见且成功的方法。炎性含牙囊肿可与接受过根管治疗的乳牙同时出现。
本文报道一例6岁6个月男孩，全景片意外发现一个边界清晰、单房、透射性的区域包绕右侧下颌第一未萌出前磨牙。右侧第一乳磨牙18个月前接受过根管治疗。临床检查结合影像学及显微镜检查确诊为炎性含牙囊肿。治疗选择囊肿摘除术并拔除受累恒牙，术后为患者提供了可摘局部义齿。5年随访显示骨病变及移位牙愈合良好。
该病例呈现了根管治疗乳牙的一种严重且罕见的并发症，建议包括：（1）含牙囊肿的早期诊断对于避免过度治疗至关重要；（2）应向患者及家长提供更多关于根管治疗不良反应的信息；（3）应告知患者随访的重要性，并将影像学随访常规化。
