Cho Young-Dan, Lee Jung-Eun, Chung Yoonjin, Lee Woo-Cheol, Seol Yang-Jo, Lee Yong-Moo, Rhyu In-Chul, Ku Young
Department of Periodontology, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Korea.
Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, BK21 Program, Seoul National University, Seoul, Korea.
J Endod. 2017 Feb;43(2):332-337. doi: 10.1016/j.joen.2016.10.003. Epub 2016 Dec 15.
This article reports 3 representative cases of interdisciplinary management of a palatogingival groove in maxillary lateral incisors. The development, pathology, and effectiveness of management approaches in cases involving a combined periodontal-endodontic lesion with a palatogingival groove are discussed.
We describe 3 patients with a noncontributory medical history presenting with a chief complaint related to a maxillary incisor and diagnosed with a combined periodontal-endodontic lesion with a palatogingival groove at Seoul National University Dental Hospital, Seoul, Korea.
Palatogingival grooves were mostly associated with deep periodontal pockets connected to a periapical lesion. Optional collaborative treatments were performed according to the condition as follows: case 1, root canal treatment (RCT), open flap debridement, odontoplasty, and guided tissue regeneration; case 2, RCT, apicoectomy, open flap debridement, and odontoplasty; and case 3, RCT, crown restoration, root planning, and odontoplasty. After clinical examination and radiographic assessments, the periapical lesion and periodontal deep pocket were successfully resolved with periodontal-endodontic collaborative treatment involving both periodontal surgical procedures (cases 1 and 2) and a nonsurgical procedure (case 3).
Within the limitations of this study, these case reports show that accurate diagnosis of developmental anomalies and elimination of inflammatory irritants are key factors for favorable long-term outcomes.
本文报告了上颌侧切牙腭龈沟多学科管理的3例典型病例。讨论了在涉及伴有腭龈沟的牙周牙髓联合病变病例中管理方法的发展、病理及有效性。
我们描述了3例无相关病史的患者,他们因上颌切牙相关主诉就诊于韩国首尔国立大学牙科学院医院,并被诊断为伴有腭龈沟的牙周牙髓联合病变。
腭龈沟大多与连接根尖周病变的深牙周袋相关。根据病情进行了如下选择性联合治疗:病例1,根管治疗(RCT)、开放瓣清创术、牙体成形术和引导组织再生术;病例2,RCT、根尖切除术、开放瓣清创术和牙体成形术;病例3,RCT、冠修复、根面平整术和牙体成形术。经过临床检查和影像学评估,通过牙周牙髓联合治疗,包括牙周手术(病例1和病例2)和非手术治疗(病例3),根尖周病变和牙周深袋均成功得到解决。
在本研究的局限性范围内,这些病例报告表明,准确诊断发育异常和消除炎症刺激物是取得良好长期疗效的关键因素。