Makeeva Maria K, Daurova Fatima Yu, Byakova Svetlana F, Turkina Anna Yu
Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia.
Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Clin Cosmet Investig Dent. 2020 Oct 28;12:447-464. doi: 10.2147/CCIDE.S267933. eCollection 2020.
The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.
牙髓和牙周组织有着明显的关联，许多研究都对此进行过描述。牙髓感染可能会影响牙周组织，反之亦然。患有牙髓-牙周联合病变的牙齿，其预后比单纯的牙髓病变或牙周病变更差。消除牙髓和牙周感染是成功治疗的关键，因此牙髓病医生和牙周病医生之间的合作是必要的。在本临床病例中，一名44岁男性因侵袭性牙周炎，右下尖牙出现原发性牙周病并继发牙髓受累。该牙临床附着丧失10毫米，近中牙周袋深度8毫米，根尖及根侧有骨质透射区。先进行了牙周治疗，随后进行牙髓治疗。牙周治疗包括龈上洁治和根面平整、用臭氧气体治疗牙周袋、全身使用抗生素、口腔卫生指导以及洗必泰漱口。牙髓治疗包括用旋转根管锉进行根管预备、冲洗、用臭氧气体进行根管治疗以及侧向加压充填。在6个月的随访复查时拍摄的X线片显示根尖病变及牙根侧方的牙槽骨完全愈合。采用多学科方法治疗牙髓-牙周联合病变可取得良好的临床效果。臭氧治疗有利于成功治疗侵袭性牙周炎且预后较差、牙周袋较窄的牙髓-牙周联合病变患者。
