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与侵袭性颈部吸收相关的内部通道吸收

Internal tunneling resorption associated with invasive cervical resorption.

作者信息

Patni Pallav Mahesh, Jain Pradeep, Jain Sumeet, Hiremath Hemalatha, Agarwal Rolly, Patni Mona Jain

机构信息

Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry (SAIMS) and Hospital, Devi Ahilya University, Indore, Madhya Pradesh, India.

Department of Prosthodontics, Sri Aurobindo College of Dentistry (SAIMS) and Hospital, Devi Ahilya University, Indore, Madhya Pradesh, India.

出版信息

J Conserv Dent. 2018 Jan-Feb;21(1):105-108. doi: 10.4103/JCD.JCD_104_17.

Abstract

Treating pathological defects that are caused by resorption in teeth can be challenging. The task is complicated further if the resorption extends beyond the restrains of the root. The aim of this report is to describe a case of extensive internal tunneling resorption (ITR) associated with invasive cervical resorption (ICR) in a maxillary right lateral incisor and its nonsurgical treatment. A 22-year-old male was referred to the department of endodontics with a chief complaint of discolored maxillary right lateral incisor or tooth 12 and a history of trauma. An extensive ITR associated with ICR accompanied by apical periodontitis was detected on a preoperative radiograph which was confirmed on a cone-beam computed tomography (CBCT) scan in a maxillary lateral incisor. After chemomechanical debridement and withdrawal of a separated file in the canal, calcium hydroxide was placed as an intracanal medicament for 2 weeks. Biodentine (BD) was used to obturate the defect as well as entire root canal system and to restore ICR. On a 5-year follow-up, the tooth was functional, and periapical healing was evident. Based on results of this case, successful repair of ITR associated with ICR with BD may lead to resolution of apical periodontitis. Trauma to teeth may lead to resorption which may be internal, external, and or a combination of both which may be asymptomatic in some patients. Preoperative assessment using CBCT imaging achieves visualization of location and extents of resorptive defects. Bioactive materials like BD may lead to favorable results in treating such extensive defects.

摘要

治疗由牙齿吸收引起的病理缺陷可能具有挑战性。如果吸收超出牙根范围,任务会更加复杂。本报告的目的是描述一例上颌右侧侧切牙广泛的内部隧道状吸收(ITR)合并侵袭性颈部吸收(ICR)及其非手术治疗的病例。一名22岁男性因上颌右侧侧切牙(即12号牙)变色及有外伤史被转诊至牙髓病科。术前X线片显示上颌侧切牙存在广泛的ITR合并ICR,并伴有根尖周炎,锥形束计算机断层扫描(CBCT)证实了这一情况。在进行化学机械清创并取出根管内分离的锉后,放置氢氧化钙作为根管内药物2周。使用生物活性牙本质(BD)封闭缺损以及整个根管系统,并修复ICR。在5年的随访中,该牙功能正常,根尖愈合明显。基于该病例的结果,用BD成功修复合并ICR的ITR可能会使根尖周炎得到缓解。牙齿外伤可能导致吸收,吸收可能是内部的、外部的或两者皆有,在某些患者中可能无症状。使用CBCT成像进行术前评估可实现对吸收性缺损的位置和范围的可视化。像BD这样的生物活性材料在治疗此类广泛缺损时可能会产生良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fef/5852926/cedcca2d4cef/JCD-21-105-g001.jpg

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