Maniglia-Ferreira Claudio, Gomes Fabio de Almeida, Vitoriano Marcelo de Morais, Lima Francisco de Assis Silva
Department of Endodontics, Course of Dentistry, University of Fortaleza, Fortaleza, CE, Brazil.
Department of Bucco-Maxillofacial Surgery, Course of Dentistry, University of Fortaleza, Fortaleza, CE, Brazil.
Case Rep Med. 2016;2016:3830987. doi: 10.1155/2016/3830987. Epub 2016 Dec 12.
This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.
本病例报告描述了一名患者下颌前部广泛病变的根管治疗及减压情况。该病变在临床和影像学检查中被发现，患者主诉下颌右侧侧切牙和尖牙区域有轻微触痛。这些牙齿未经适当临床评估就被开髓，牙髓组织暴露。牙周组织健康，无炎症或瘘管迹象。影像学检查显示，一个边界清晰的透射性病变从下颌左第二前磨牙远中根延伸至下颌右第二前磨牙近中根。下颌左中切牙和侧切牙对牙髓温度测试无反应，且牙冠变色，符合牙髓坏死的诊断。尽管在根管治疗过程中应用了根管内药物（氢氧化钙糊剂），根管系统仍持续有渗出物，因此决定对病变进行活检和减压，并完成根管治疗。组织病理学检查显示为根尖肉芽肿。对患牙进行根管治疗后，经过4年的临床和影像学随访，受影响区域几乎完全修复。
