Romano Nayara, Souza-Flamini Luis Eduardo, Mendonça Isabela Lima, Silva Ricardo Gariba, Cruz-Filho Antonio Miranda
Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Case Rep Dent. 2016;2016:3759021. doi: 10.1155/2016/3759021. Epub 2016 Dec 29.
This paper reports a case of gemination in a maxillary lateral incisor with two root canals and crown-root dilaceration. A 16-year-old male patient was referred for endodontic treatment of the maxillary left lateral incisor and evaluation of esthetic and functional complaints in the anterior region. The patient reported trauma to the anterior primary teeth. There was no spontaneous pain, but the tooth responded positively to the vertical percussion test and negatively to the pulp vitality test. Clinical examination showed esthetic and functional alterations and normal periodontal tissues. CBCT imaging confirmed the suspicion of gemination and crown-root dilaceration and also revealed the presence of two root canals and periapical bone rarefaction. The root canals were instrumented with Reciproc R40 and 1% NaOCl irrigation and were filled by lateral condensation of gutta-percha and AH Plus sealer. The tooth was definitely restored with composite resin to recover esthetics. Continued follow-up over 6 months has shown absence of pain or clinical alterations as well as radiographic image suggestive of apical repair.
本文报告了一例上颌侧切牙双根管伴冠根折曲融合牙的病例。一名16岁男性患者因上颌左侧侧切牙的牙髓治疗以及对前部区域美观和功能问题的评估前来就诊。患者自述上前乳牙曾受过外伤。无自发痛,但该牙对垂直叩诊试验反应阳性,对牙髓活力测试反应阴性。临床检查发现存在美观和功能改变,牙周组织正常。锥形束计算机断层扫描(CBCT)成像证实了融合牙及冠根折曲的怀疑,还显示存在两个根管以及根尖周骨质稀疏。根管采用Reciproc R40器械预备,1%次氯酸钠冲洗,并用牙胶侧向加压充填和AH Plus封闭剂封闭。该牙最终用复合树脂修复以恢复美观。6个月的持续随访显示无疼痛或临床改变,影像学图像提示根尖修复。