Department of Endodontology, School of Dentistry, Ege University, Izmir, Turkey.
Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey.
Int Endod J. 2018 Jan;51(1):128-137. doi: 10.1111/iej.12784. Epub 2017 May 29.
To present the regenerative endodontic treatment procedure of a perforated internal root resorption case and its clinical and radiographic findings after 2 years.
A 14-year-old female patient was referred complaining of moderate pain associated with her maxillary left lateral incisor. After radiographic examination, a perforated internal resorption lesion in the middle third of tooth 22 was detected. Under local anaesthesia and rubber dam isolation, an access cavity was prepared and the root canal was shaped using K-files under copious irrigation with 1% NaOCl, 17% EDTA and distilled water. At the end of the first and second appointments, calcium hydroxide (CH) paste was placed in the root canal using a lentulo. After 3 months, the CH paste was removed using 1% NaOCl and 17% EDTA solutions and bleeding in the root canal was achieved by placing a size 20 K-file into the periapical tissues. Mineral trioxide aggregate was then placed over the blood clot. The access cavity was restored using glass-ionomer cement and resin composite. After 2 years, the tooth was asymptomatic and radiographic examination revealed hard tissue formation in the perforated resorption area and remodelling of the root surface.
Regenerative endodontic treatment procedures are an alternative approach to treat perforated internal root resorption lesions. Calcium hydroxide was effective as an intracanal medicament in regenerative endodontic treatment procedures.
介绍一例穿孔性内吸收根管治疗的再生治疗过程及其 2 年后的临床和影像学发现。
一位 14 岁的女性患者因上颌左侧侧切牙中度疼痛就诊。经过影像学检查,发现 22 号牙中三分之一处有穿孔性内吸收病变。在局部麻醉和橡皮障隔离下,制备一个进入腔,并使用大量 1%次氯酸钠、17% EDTA 和蒸馏水冲洗,用 K 锉进行根管塑形。在第一和第二次就诊的最后,使用 lentulo 将氢氧化钙(CH)糊剂置于根管中。3 个月后,使用 1%次氯酸钠和 17% EDTA 溶液去除 CH 糊剂,并通过将 20 号 K 锉插入根尖组织来实现根管内出血。然后在血液凝块上放置三氧化矿物聚合体。使用玻璃离子水门汀和树脂复合材料修复进入腔。2 年后,牙齿无症状,影像学检查显示穿孔性吸收区域有硬组织形成和根表面重塑。
再生性牙髓治疗程序是治疗穿孔性内吸收病变的一种替代方法。氢氧化钙在再生性牙髓治疗程序中作为根管内药物是有效的。