Hirata-Tsuchiya Shizu, Suzuki Shigeki, Nakamoto Takashi, Kakimoto Naoya, Yamada Satoru, Shiba Hideki
Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.
Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan.
Dent J (Basel). 2020 Nov 20;8(4):131. doi: 10.3390/dj8040131.
The spread of root canal infection to surrounding periodontal tissue through accessory root canals reduces the success rate of endodontic treatment. In this case, cone-beam computed tomography revealed a lesion (4 mm from the apex) resulting from an accessory root canal of the maxillary left central incisor. First, non-surgical endodontic treatment was conducted but the sinus tract remained. Surgical preparation of the root cavity was then conducted to remove potentially infected dentin surrounding the accessory root canal. The cavity was filled and the foramen was sealed with resin containing bioactive surface pre-reacted glass (S-PRG) filler. The photopolymerized resin was then contoured and polished. In combination with subsequent supportive non-surgical endodontic treatment, a good clinical outcome with the disappearance of the sinus tract and clinical symptoms such as discomfort and pressure pain and the regeneration of the alveolar bone hanging over the cavity was obtained. In this case, the good clinical outcome may have been due to the dentin-adhesive property and durability of the pre-adhesive system and composite resin. The better biocompatibility of S-PRG fillers presumably facilitated periodontal tissue healing.
根管感染通过副根管扩散至周围牙周组织会降低牙髓治疗的成功率。在此病例中，锥形束计算机断层扫描显示上颌左侧中切牙的副根管导致根尖4毫米处出现病变。首先进行了非手术牙髓治疗，但窦道仍存在。随后进行了根管手术预备，以去除副根管周围可能感染的牙本质。根管充填，并用含生物活性表面预反应玻璃（S-PRG）填料的树脂封闭根尖孔。然后对光固化树脂进行塑形和抛光。结合后续的支持性非手术牙髓治疗，获得了良好的临床效果，窦道消失，不适和压痛等临床症状消失，牙槽骨在根管上方再生。在此病例中，良好的临床效果可能归因于预粘结系统和复合树脂的牙本质粘结性能及耐久性。S-PRG填料更好的生物相容性可能促进了牙周组织愈合。
