Ali Afzal, Arslan Hakan
Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, RJ, India.
Department of Endodontics, Faculty of Dentistry, Istanbul Health Sciences University, Istanbul, Turkey.
Restor Dent Endod. 2019 Oct 21;44(4):e38. doi: 10.5395/rde.2019.44.e38. eCollection 2019 Nov.
Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.
在临床实践中，主根管的探查以及处理牙中牙是一项具有挑战性的任务。近来，引导式牙髓治疗技术已成为一种用于进入根管、手术腔隙和钙化根管的替代方法，且不会对组织造成医源性损伤。在本病例报告中，描述了引导式牙髓治疗技术用于两颗患有多个牙中牙的上颌侧切牙的情况。一名16岁女性患者因上前牙疼痛和变色为主诉前来就诊。根据临床和影像学检查结果，对上颌左侧侧切牙（22号牙）诊断为牙髓坏死和与双牙中牙（奥勒二类）相关的慢性根尖周脓肿。计划对22号牙进行根管治疗并用三氧化矿物凝聚体封闭双牙中牙。对于12号牙（奥勒二类），计划对牙中牙进行预防性封闭。使用引导式牙髓治疗技术对上颌22号牙的双牙中牙和主根管以及12号牙的牙中牙实现了微创进入。该技术可能是一种有价值的工具，因为它减少了椅旁操作时间，更重要的是，降低了对牙齿结构造成医源性损伤的风险。
