Sockalingam S Nagarajan M P, Awang Talip Mohd Safwani Affan Alli, Zakaria Ahmad Shuhud Irfani
Centre for Family Oral Health, Faculty of Dentistry, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia.
Case Rep Dent. 2018 Jun 7;2018:6535480. doi: 10.1155/2018/6535480. eCollection 2018.
Dens evaginatus is a dental developmental anomaly that arises due to the folding of the inner dental epithelium that leads to the formation of an additional cusp or tubercle on the occlusal surface of the affected tooth. This accessory tissue projection may carry with it a narrow and constricted pulp horn extension. Occasionally, the tubercle easily fractures, thus leading to microexposure of the pulp horn and eventual pulp necrosis. Often, the pulp necrosis occurs at a time the root development of the affected tooth is incomplete. Apexification with calcium hydroxide and mineral trioxide aggregates has been the mainstay of treatment options before root canal obturation in immature nonvital permanent teeth. Lately, regenerative endodontics (maturogenesis) is becoming one of the preferred treatment modalities to manage such teeth. The current case highlights the possibility of a bioceramic material (EndoSequence Root Repair Material, BC RRM-Fast Set Putty™, Brasseler, USA) which supposed to provide apical root closure (apexification) and could also induce continuation of root growth (maturogenesis).
畸形中央尖是一种牙齿发育异常，它是由于牙内上皮折叠导致在患牙的咬合面上形成一个额外的牙尖或结节。这种附属组织突起可能伴有一个狭窄且受限的髓角延伸。偶尔，结节容易折断，从而导致髓角微暴露并最终引起牙髓坏死。通常，牙髓坏死发生在患牙根发育不完全的时候。在未成熟恒牙非活髓根管充填之前，用氢氧化钙和三氧化矿物凝聚体进行根尖诱导成形术一直是主要的治疗选择。最近，再生牙髓治疗（成熟化）正成为处理这类牙齿的首选治疗方式之一。本病例突出了一种生物陶瓷材料（EndoSequence根修复材料，BC RRM - 快速凝固糊剂™，美国Brasseler公司）的可能性，该材料应能实现根尖封闭（根尖诱导成形），还能诱导牙根继续生长（成熟化）。
