Abazarpour Ramin, Parirokh Masoud, Farhadi Aida, Jalali Zahra, Kheirabadi Nasir
Private Practice, Zahedan, Iran.
Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Iran Endod J. 2017 Summer;12(3):390-395. doi: 10.22037/iej.v12i3.16559.
Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.
牙内陷是最常见的牙齿结构异常之一。它是由牙胚发育期间牙冠表面内陷进入患牙的牙髓腔所致。根据内陷的复杂程度，牙齿可能会出现牙髓坏死、根尖孔开放和复杂的根管系统。本病例报告展示了一例下颌前磨牙的2型奥氏牙内陷伴慢性根尖脓肿。在大多数情况下，牙内陷在治疗过程中会被去除。然而，在本病例报告中，基于锥形束计算机断层扫描（CBCT）评估，选择了非手术治疗并保留内陷部分，以防止破坏牙齿结构及其未来发生牙根折断的易感性。这是一种新的治疗方法，之前的报告中尚未有过。使用富钙混合（CEM）水门汀作为根尖充填物，随后采用热垂直加压法用牙胶进行根管充填。治疗后对该病例进行了36个月的随访。本报告强调了基于CBCT评估选择合适治疗方法的重要性。
