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牙再植术后外吸收的保守治疗:3年随访

Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

作者信息

Ionta Franciny Querobim, de Oliveira Gabriela Cristina, de Alencar Catarina Ribeiro Barros, Gonçalves Priscilla Santana Pinto, Alcalde Murilo Priori, Minotti Paloma Gagliardi, Machado Maria Aparecida de Andrade Moreira, Rios Daniela

出版信息

Gen Dent. 2016 Jul-Aug;64(4):42-6.

Abstract

The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered.

摘要

本病例报告旨在描述一名9岁患者的治疗情况,该患者在左上中切牙和侧切牙脱位再植后,出现了上颌左侧恒侧切牙的牙根外吸收。在医院急诊科对切牙进行再植和夹板固定16天后,患者被送往一所牙科学院的儿科进行进一步治疗。在上颌左侧侧切牙和中切牙建立根管通路,并使用氢氧化钙糊剂作为根管内敷料。在5个月的随访中,一张X光片显示广泛的牙根外吸收、根管相通以及影响左侧侧切牙的牙周病变。牙根吸收的处理包括用牙胶尖充填根管的根尖三分之一,用三氧化矿物凝聚体(MTA)充填根管的中间三分之一。在3年的复查中,患者无症状,临床未观察到牙齿松动或软组织改变。没有影像学迹象表明吸收有进展。尽管治疗成功,但仍需观察。MTA的使用可被视为牙齿再植后牙根外吸收的一种替代治疗方法。该技术可能使儿童的牙齿得以保留,直到骨骼生长发育完成并可考虑进行种植治疗。

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