Karunakaran J V, Fenn Susan Mathew, Jayaprakash N, Ragavendran N
Department of Conservative Dentistry, JKK Nataraja Dental College, Namakkal, Tamil Nadu, India.
J Pharm Bioallied Sci. 2017 Nov;9(Suppl 1):S268-S273. doi: 10.4103/jpbs.JPBS_126_17.
Palatogingival groove also known as radicularlingual groove is a developmental anomaly involving the lingual surface of the maxillary incisors. They are inconspicuous, funnel-shaped, extend for varying distances on root surface and occur due to infolding of the hertwigs epithelial root sheath. This encourages adherence of microorganisms and plaque to levels significant for pathological changes resulting in endodontic and periodontal lesions. The variations in anatomy of the tooth as a cause of pulp necrosis in teeth of anterior maxillary segment should be considered by the clinician when other etiological factors are ruled out. Recognition of palatogingival groove is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated. Regeneration is a new emerging approach in endodontics. Choukroun . were among the pioneers for using platelet-rich fibrin (PRF) to improve bone healing. PRF is rich in platelet cytokines and growth factors. Numerous techniques have been used to eliminate or seal the groove and regenerate endodontic and periodontal tissues. In this case report of two cases, a novel combination therapy involving ultrasonics, blend of PRF with bone graft, guided tissue regeneration membrane was used in the treatment of a palatogingival groove with an endoperio lesion to ensure arrest of disease progression and promote regeneration. The groove was cleaned and prepared ultrasonically and sealed with a bioactive dentin substitute.
腭龈沟也称为根舌沟，是一种涉及上颌切牙舌面的发育异常。它们不明显，呈漏斗状，在牙根表面延伸不同距离，是由赫特维希上皮根鞘内陷引起的。这会促使微生物和牙菌斑附着到足以导致病理变化的程度，从而引发牙髓和牙周病变。当排除其他病因时，临床医生应考虑牙齿解剖结构的变异作为上颌前部牙髓坏死的原因。认识腭龈沟至关重要，特别是因为其诊断复杂，若未正确解读和治疗可能会出现问题。再生是牙髓病学中一种新兴的方法。舒克伦等人是使用富血小板纤维蛋白（PRF）促进骨愈合的先驱之一。PRF富含血小板细胞因子和生长因子。已经使用了多种技术来消除或封闭该沟，并使牙髓和牙周组织再生。在这例两例患者的病例报告中，一种新的联合治疗方法，即超声治疗、PRF与骨移植的混合以及引导组织再生膜，被用于治疗伴有牙髓牙周联合病变的腭龈沟，以确保疾病进展得到控制并促进再生。用超声清洁并预备该沟，并用生物活性牙本质替代物封闭。
