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锥形束 CT 分析对晚期牙颈部吸收的治疗方式选择有帮助:一项回顾性分析。

CBCT analyses of advanced cervical resorption aid in selection of treatment modalities: a retrospective analysis.

机构信息

Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Israel.

出版信息

Clin Oral Investig. 2019 Apr;23(4):1635-1640. doi: 10.1007/s00784-018-2592-x. Epub 2018 Aug 26.

Abstract

OBJECTIVES

The selection of treatment for advanced (classes 3 and 4) invasive cervical resorption (ICR) based on a two-dimensional periapical radiograph is challenging. The purpose of the present study is to describe different treatment approaches for advanced invasive cervical resorption based on cone-beam computed tomography evaluation.

MATERIALS AND METHODS

All cases of advanced ICR based on CBCT evaluation in our endodontic department between 2011 and 2016 were included in the study. The dimension, circumferential, and coronal-cervical locations of the entry point of the resorption tissue into the tooth were evaluated. The selected treatment approach for each case was documented, and all the data were summarized and analyzed.

RESULTS

Twenty-three cases of advanced ICR were included in the study. Approximately, 74% were diagnosed in stage 4, and 26% were diagnosed in stage 3. The narrow entry point was identified in 43% (10 cases), while in 57% (13) of cases, the entry point was wide. Circumferentially, 70% (16) were located on the proximal side. Coronal-cervically, 43% (10) were located more than 1.5 mm above the crestal bone. All narrow entry point cases were treated using a minimally invasive technique, while different treatment approaches were chosen for cases with a wide entry point.

CONCLUSIONS

The present study proposes different treatment approaches for advanced ICR based on CBCT. The CBCT evaluation of the entry point may facilitate choosing the appropriate treatment approach for advanced ICR cases.

CLINICAL RELEVANCE

The description of different treatment approaches for advanced invasive cervical resorption based on cone-beam computed tomography evaluation enables the clinician to choose the optimal treatment approach for each advanced ICR case.

摘要

目的

基于二维根尖片选择治疗晚期(3 级和 4 级)侵袭性颈吸收(ICR)具有挑战性。本研究的目的是描述基于锥形束 CT 评估的晚期侵袭性颈吸收的不同治疗方法。

材料和方法

本研究纳入了 2011 年至 2016 年期间我们牙髓病学部门基于 CBCT 评估的所有晚期 ICR 病例。评估了吸收组织进入牙齿的入口点的尺寸、周向和冠颈位置。记录了每个病例的选定治疗方法,并总结和分析了所有数据。

结果

本研究纳入了 23 例晚期 ICR。大约 74%的病例被诊断为 4 期,26%的病例被诊断为 3 期。43%(10 例)的病例入口狭窄,57%(13 例)的病例入口较宽。周向方面,70%(16 例)位于近侧。冠颈方面,43%(10 例)位于距牙槽嵴骨顶上方 1.5 毫米以上。所有入口狭窄的病例均采用微创技术治疗,而入口较宽的病例则选择了不同的治疗方法。

结论

本研究基于 CBCT 为晚期 ICR 提出了不同的治疗方法。入口点的 CBCT 评估可以帮助选择晚期 ICR 病例的合适治疗方法。

临床意义

描述基于锥形束 CT 评估的晚期侵袭性颈吸收的不同治疗方法,使临床医生能够为每个晚期 ICR 病例选择最佳的治疗方法。

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