Schmoeckel Julian, Mourad Mhd Said, Splieth Christian H, Santamaria Ruth M
Quintessence Int. 2017;48(4):309-313. doi: 10.3290/j.qi.a37801.
Root canal treatment of immature teeth is considered a great challenge for both the dentist and the patient. The thinness of the root canals walls and the lack of an apical barrier leads to unpredictable treatment results. Revascularization is a novel promising treatment option in the field of regenerative endodontics for management of immature necrotic permanent teeth. This case presents a successful treatment of an 8-year-old patient with a partially necrotic, immature permanent mandibular right first molar pulp by revascularization. The revascularization procedure was performed in two appointments using nitrous oxide sedation to reduce the child's anxiety during treatment. Following root canal disinfection with NaOCl, a triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline) was applied into the canal. One week later, induction of bleeding, application of MTA, and tooth restoration using a stainless steel crown were performed. At the subsequent follow-up appointments (3, 9, and 16 months) the tooth was asymptomatic. After 2 years a radiographic assessment revealed complete periapical healing and apical closure, as well as increase in root length and dentin thickness.
This case supports the evidence of revascularization as a biological treatment option for the management of necrotic young permanent teeth.
对于牙医和患者而言，未成熟恒牙的根管治疗都被认为是一项巨大挑战。根管壁薄以及缺乏根尖屏障会导致治疗结果不可预测。再血管化是再生牙髓病学领域中用于治疗未成熟坏死恒牙的一种新的、有前景的治疗选择。本病例展示了通过再血管化成功治疗一名8岁患者的部分坏死、未成熟的下颌右第一恒磨牙牙髓。再血管化治疗分两次就诊进行，使用笑气镇静以减轻患儿在治疗过程中的焦虑。用次氯酸钠进行根管消毒后，将三联抗生素糊剂（环丙沙星、甲硝唑和米诺环素）应用于根管。一周后，诱导出血、应用MTA并使用不锈钢冠修复牙齿。在随后的随访就诊（3个月、9个月和16个月）时，该牙齿无症状。2年后，影像学评估显示根尖完全愈合且根尖封闭，以及牙根长度和牙本质厚度增加。
本病例支持再血管化作为治疗坏死年轻恒牙的一种生物学治疗选择的证据。
