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正畸治疗后侵袭性颈部吸收:两例涉及同一患者的病例。

Invasive cervical resorption following orthodontic treatment: Two cases involving the same patient.

作者信息

Yoshpe Margarita, Kaufman Arieh, Lin Shaul, Gabay Eran, Einy Shmuel

出版信息

Quintessence Int. 2016;47(10):877-884. doi: 10.3290/j.qi.a36889.

Abstract

UNLABELLED

Invasive cervical resorption (ICR), a destructive form of external root resorption, is characterized by invasion of the fibrovascular tissue. This phenomenon is very rare and appears in 0.02% of the general population where the leading factors are orthodontics in addition to trauma, restorations, and bleaching. Heavy orthodontic force may increase the incidence to 1%. One of the main concerns regarding ICR is that it is often misdiagnosed with conventional diagnostic tools. In recent decades, a cone beam computed tomography (CBCT) imaging technique has become more common and can lead to a more accurate diagnosis and treatment plan. This case report describes a possible association between orthodontic treatment and ICR of a 14-year-old male, 18 months post orthodontic treatment. ICR in the mandibular right canine was diagnosed and verified by CBCT, and underwent combined endodontic-periodontal treatment. However, after orthodontic forced eruption was performed on this tooth to improve the bone defect, ICR was diagnosed on the mandibular right second premolar. The possible association between orthodontic treatment and ICR is discussed, as ICR was noted following orthodontic treatment on both occasions. This case report stresses the importance of ICR early detection by close attention to periodic radiographic checkups during orthodontic treatment. The use of modern diagnostic tools is highly recommended in suspicious cases.

CONCLUSION

A case is described in which the patient underwent two types of orthodontic treatment in the mandible at different time periods and developed ICR in two different teeth.

摘要

未加标注

侵袭性颈部吸收(ICR)是一种外部牙根吸收的破坏性形式,其特征是纤维血管组织侵入。这种现象非常罕见,在普通人群中的发生率为0.02%,主要因素除了创伤、修复和漂白外,还有正畸治疗。强大的正畸力可能会使发生率增加到1%。关于ICR的主要担忧之一是,它经常被传统诊断工具误诊。近几十年来,锥形束计算机断层扫描(CBCT)成像技术变得更加普遍,能够带来更准确的诊断和治疗方案。本病例报告描述了一名14岁男性在正畸治疗后18个月,正畸治疗与ICR之间可能存在的关联。下颌右侧尖牙的ICR通过CBCT诊断并得到证实,并接受了牙髓-牙周联合治疗。然而,在对该牙进行正畸牵引以改善骨缺损后,下颌右侧第二前磨牙被诊断出ICR。由于两次正畸治疗后均发现了ICR,因此讨论了正畸治疗与ICR之间可能的关联。本病例报告强调了在正畸治疗期间密切关注定期影像学检查以早期发现ICR的重要性。对于可疑病例,强烈建议使用现代诊断工具。

结论

描述了一例患者在不同时间段下颌接受了两种正畸治疗,并在两颗不同牙齿上发生ICR的病例。

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