Liu Jie, Zhang Yue-Rong, Zhang Fu-Yu, Zhang Guang-Dong, Xu Hai
Department of General Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
World J Clin Cases. 2020 Mar 26;8(6):1150-1157. doi: 10.12998/wjcc.v8.i6.1150.
Invaginated teeth pose greater challenges in clinical management because of their complex configuration. With advancements in equipment and materials, such as the dental operation microscope, cone-beam computed tomography and mineral trioxide aggregate, the preservation rate of type III dens invaginatus could be greatly increased.
This case report presented a 31-year-old woman with complaints of spontaneous swelling and pain in the right maxillary lateral tooth. With the aid of cone-beam computed tomography, type III dens invaginatus with apical periodontitis was diagnosed and confirmed. Three-visit endodontic treatment was performed. In the first visit, the invagination was carefully removed under the dental operation microscope, and chemomechanical preparation was done. In the second visit, mineral trioxide aggregate apical barrier surgery was performed in this tooth. In the third visit, the canal was finally obturated with thermoplastic gutta-percha to recover the crown morphology. A 26-mo follow-up revealed a satisfied outcome both in the radiographic and oral examinations.
In this case, removal of the entire abnormal structure provided great convenience for the follow-up treatment. When confronted with the same clinical case in the future, we can take a similar approach to address it.
由于其复杂的结构，内陷牙在临床处理上面临更大的挑战。随着牙科手术显微镜、锥形束计算机断层扫描和三氧化矿物凝聚体等设备和材料的进步，III型牙内陷的保存率可大大提高。
本病例报告介绍了一名31岁女性，主诉右上颌侧切牙自发肿胀和疼痛。借助锥形束计算机断层扫描，诊断并确诊为III型牙内陷伴根尖周炎。进行了三次就诊的根管治疗。第一次就诊时，在牙科手术显微镜下小心去除内陷部分，并进行化学机械预备。第二次就诊时，对该牙进行了三氧化矿物凝聚体根尖屏障术。第三次就诊时，最终用热塑性牙胶充填根管以恢复牙冠形态。26个月的随访显示，影像学和口腔检查结果均令人满意。
在本病例中，去除整个异常结构为后续治疗提供了极大便利。未来遇到相同临床病例时，我们可以采取类似方法进行处理。
