Timmerman Aovana, Parashos Peter
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia.
J Endod. 2017 Feb;43(2):252-256. doi: 10.1016/j.joen.2016.10.024. Epub 2016 Dec 29.
This case report presents the treatment of a 16-year-old boy with a maxillary lateral incisor (tooth #10) presenting with Oehlers type II dens invaginatus and diagnosed with previously initiated therapy and asymptomatic apical periodontitis.
A regenerative endodontic procedure (REP) was performed for the tooth but complicated by apically displaced mineral trioxide aggregate (MTA). Clinical and radiographic examination was undertaken yearly, and a cone-beam computed tomography scan was taken to investigate further the formation of hard tissues within the root canal. Subsequently, tooth #10 was re-accessed and then root-filled with MTA.
There was complete periapical healing, thickening of the dentinal root walls, and completed apex formation 3 years after REP. Hard tissue formation was noted within the root canal, on the root canal wall, and the root apex through clinical and radiographic examination. Less hard tissue formation was noted on the labial root canal wall where the displaced MTA was located, which was identified on the cone-beam computed tomography scan.
This report demonstrates that REP can potentially provide excellent treatment outcomes for structurally compromised teeth. REP should be considered as a first-line treatment before proceeding with a root filling when root development is incomplete, but attention to technical detail is essential.
本病例报告介绍了一名16岁男孩上颌侧切牙（10号牙）的治疗情况，该牙患有奥勒尔斯II型牙内陷，并被诊断为先前已开始治疗且无症状的根尖周炎。
对该牙进行了再生性牙髓治疗（REP），但因根尖移位的三氧化矿物凝聚体（MTA）而出现并发症。每年进行临床和影像学检查，并进行锥形束计算机断层扫描以进一步研究根管内硬组织的形成情况。随后，重新打开10号牙，然后用MTA进行根管充填。
再生性牙髓治疗3年后，根尖完全愈合，牙本质根壁增厚，根尖形成完成。通过临床和影像学检查发现根管内、根管壁和根尖有硬组织形成。在锥形束计算机断层扫描中确定的移位MTA所在的唇侧根管壁上，硬组织形成较少。
本报告表明，再生性牙髓治疗对于结构受损的牙齿可能提供优异的治疗效果。当牙根发育不完全时，在进行根管充填之前，再生性牙髓治疗应被视为一线治疗方法，但注意技术细节至关重要。
