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使用生物陶瓷通过外科根管重建术治疗根管狭窄和外部炎性吸收

Management of root canal stenosis and external inflammatory resorption by surgical root reconstruction using biodentine.

作者信息

Agrawal Vineet Suresh, Kapoor Sonali

机构信息

Department of Conservative Dentistry and Endodontics, M. P. Dental College and Hospital, Vadodara, Gujarat, India.

出版信息

J Conserv Dent. 2020 Jan-Feb;23(1):102-106. doi: 10.4103/JCD.JCD_128_20. Epub 2020 Oct 10.

Abstract

Root canal stenosis and external inflammatory root resorption are potential consequence of trauma that can occur depending on the severity of the injury. Luxation injuries induce reduced blood supply to the pulp, which leads to calcification/narrowing of root canals leading to root canal stenosis. External inflammatory cervical resorption occurs when there has been the loss of cementum due to damage to the external surface of tooth root during trauma, plus root canal system becoming infected with bacteria. External inflammatory resorption can ultimately lead to loss of tooth if it is not managed in a timely manner. The treatment should aim toward the complete suppression of all tissues undergoing resorption and the reconstruction of the resorptive defect by the placement of a suitable bioactive material. This case report presents the management of root canal stenosis in the maxillary left central incisor in 35-year-old female and management of Class IV external invasive cervical and apical inflammatory resorption in maxillary right central incisor, both of which were diagnosed with the help of cone-beam computed tomography scan. The treatment of external inflammatory resorption included surgical excision of granulation tissue and root reconstruction with Biodentine. Twelve months follow-up showed successful outcomes for both the teeth treated for root canal stenosis and external invasive inflammatory resorption leading retention of the traumatized teeth with otherwise poor prognosis.

摘要

根管狭窄和外部炎性牙根吸收是创伤的潜在后果,其发生取决于损伤的严重程度。牙脱位损伤会导致牙髓血供减少,进而导致根管钙化/狭窄,引起根管狭窄。当外伤导致牙根外表面受损致使牙骨质丧失,且根管系统被细菌感染时,就会发生外部炎性颈部吸收。如果不及时处理,外部炎性吸收最终可能导致牙齿脱落。治疗应旨在完全抑制所有正在发生吸收的组织,并通过放置合适的生物活性材料来重建吸收性缺损。本病例报告介绍了一名35岁女性上颌左中切牙根管狭窄的治疗情况,以及上颌右中切牙IV类外部侵袭性颈部和根尖炎性吸收的治疗情况,这两例均借助锥形束计算机断层扫描进行诊断。外部炎性吸收的治疗包括手术切除肉芽组织并用BioDentine进行牙根重建。十二个月的随访显示,接受根管狭窄和外部侵袭性炎性吸收治疗的两颗牙齿均取得了成功的治疗效果,使原本预后不佳的外伤牙齿得以保留。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d2c/7657415/4d23f205593f/JCD-23-102-g001.jpg

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