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牙髓石的临床情况:病例报告系列

Clinical aspects of pulp stones: A case report series.

作者信息

Pietrzycka Krystyna, Pawlicka Halina

机构信息

Department of Endodontics, Medical University of Lodz, Poland.

出版信息

Dent Med Probl. 2020 Apr-Jun;57(2):213-220. doi: 10.17219/dmp/117944.

Abstract

Pulp stones (PSs) are calcified masses that can be found in the pulp cavity of any deciduous or permanent tooth. They can be observed in healthy, diseased, and even unerupted or impacted teeth. Calcifications within the pulp may lead to a poorer outcome of a root canal procedure, as they can block access to the root canals, and hinder their subsequent cleaning and shaping. The paper describes 4 clinical cases of denticles located in the coronal and radicular pulp. Therapeutic methods of PS removal with different techniques and instruments are discussed. Specialist root canal treatment (RCT) was performed in aseptic conditions with the use of long-shank rose-head burs and an endodontic ultrasonic device under the magnification of a dental operative microscope (OM). During endodontic treatment, all PSs were totally removed, which allowed the further preparation, and finally obturation of the canal system. The use of modern diagnostic and therapeutic methods - three-dimensional (3D) diagnostic radiology, endodontic techniques, such as ultrasounds used during the removal of PSs and the irrigation of the canals, and the thermoplastic methods of canal obturation - can provide good results of treatment of this pathology. The removal of PSs from the pulp cavity is a complex and difficult procedure, requiring skill, dexterity, and appropriate equipment and facilities. The clinical approach introduced in this paper allows endodontists to avoid potential complications like perforation, the unnecessary removal of hard tissues or the weakening of the tooth structure.

摘要

牙髓石(PSs)是在任何乳牙或恒牙的牙髓腔中都能发现的钙化团块。它们可在健康、患病甚至未萌出或阻生的牙齿中观察到。牙髓内的钙化可能导致根管治疗的预后较差,因为它们会阻碍进入根管,并妨碍随后的清理和塑形。本文描述了4例位于冠髓和根髓的髓石临床病例。讨论了使用不同技术和器械去除PSs的治疗方法。在牙科手术显微镜(OM)放大倍数下,使用长柄玫瑰头车针和牙髓超声设备,在无菌条件下进行专业根管治疗(RCT)。在根管治疗过程中,所有PSs均被完全去除,从而得以进一步预备根管,并最终完成根管系统的充填。使用现代诊断和治疗方法——三维(3D)诊断放射学、牙髓技术,如去除PSs和冲洗根管时使用的超声,以及根管充填的热塑性方法——可以为这种病理状况提供良好的治疗效果。从牙髓腔中去除PSs是一个复杂且困难的过程,需要技巧、灵活性以及合适的设备和设施。本文介绍的临床方法可使牙髓病医生避免诸如穿孔、不必要地去除硬组织或削弱牙齿结构等潜在并发症。

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