Park Hyon-Beom, Lee Bin-Na, Hwang Yun-Chan, Hwang In-Nam, Oh Won-Mann, Chang Hoon-Sang
Department of Conservative Dentistry, Chonnam National University School of Dentistry, Gwangju, Korea.
Restor Dent Endod. 2015 Nov;40(4):322-7. doi: 10.5395/rde.2015.40.4.322. Epub 2015 Aug 28.
A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.
近期,针对年轻患者非活髓未成熟恒牙的一种治疗选择是使用三联抗生素糊剂(TAP)进行血管再生。然而,有报道称使用传统含米诺环素的TAP会导致牙齿变色。在本病例报告中,使用含阿莫西林的TAP对非活髓未成熟恒牙进行血管再生,以防止牙齿变色。在1年的随访中,临床检查发现这些牙齿无症状,且牙冠变色轻微,变色原因是使用了三氧化矿物凝聚体(MTA)充填而非含阿莫西林的TAP。影像学检查显示根尖周透射影完全消失,根尖闭合,牙周膜间隙明显。然而,牙根生长受限,治疗结果更像是根尖诱导成形术而非血管再生。这些结果可能是由于血凝块形成不稳定,无法抵抗MTA充填的压力,无论是否使用了胶原基质。这些病例表明,尽管血管再生未成功,但可预期实现根尖诱导成形术,从而使根尖周透射影消失且根尖闭合。因此,尝试对年轻患者的非活髓未成熟恒牙进行血管再生是值得的。