Asgary Saeed, Roghanizadeh Leyla
Iranian Center For Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran Endod J. 2018 Winter;13(1):135-138. doi: 10.22037/iej.v13i1.19369.
Actinomycosis is a rare lesion of the jaws and may present as periapical pathosis; therefore, it is essential to be correctly diagnosed and managed. This case presentation describes management of a tooth with a symptomatic apical periodontitis caused by species supplemented with medicine prescription. A woman was referred for endodontic management of tooth #19. The tooth had a history of previous nonsurgical endodontic retreatment. Clinically, the tooth was very sensitive to percussion. Radiographic evaluation showed a large periapical lesion. Intentional replantation (IR) was planned. The tooth was atraumatically extracted. Without any curettage, through the blood flow coming out of the socket, a small yellowish granule was detected and sent for examination. After root-end preparations, the cavities were filled with calcium-enriched mixture cement and the tooth was carefully replanted. Histopathological assessment proved actinomycosis sulfur granule. According to infectious disease specialist recommendation, low-dose and long-term penicillin V was prescribed. Interestingly, at 2-month follow-up, remarkable bone healing was observed. In the cases of apical actinomycosis, IR in combination with antibiotic therapy, even without the curettage of the lesion, may be successfully employed.
放线菌病是颌骨的一种罕见病变，可能表现为根尖周病变；因此，正确诊断和处理至关重要。本病例报告描述了对一颗因放线菌属引起的有症状根尖周炎的牙齿进行的处理，并辅以药物处方。一名女性因19号牙的牙髓治疗被转诊。该牙有既往非手术牙髓再治疗史。临床上，该牙对叩诊非常敏感。影像学评估显示有一个大的根尖周病变。计划进行意向性再植（IR）。该牙被无创拔除。未进行任何刮治，通过牙槽窝流出的血液，发现了一个小黄颗粒并送去检查。在进行根尖预备后，根管腔用富钙混合水门汀充填，然后小心地将牙齿再植。组织病理学评估证实为放线菌病硫磺颗粒。根据传染病专家的建议，开具了低剂量、长期的青霉素V。有趣的是，在2个月的随访中，观察到了显著的骨愈合。在根尖放线菌病的病例中，意向性再植联合抗生素治疗，即使不刮除病变，也可能成功应用。
