Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut.
Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut.
J Endod. 2021 Mar;47(3):526-531. doi: 10.1016/j.joen.2020.12.006. Epub 2021 Jan 17.
Three-dimensional (3D)-printed guides have been used in endodontics to prepare a conservative access, locate calcified or missing canals, and perform precisive osteotomy in apicoectomy. Here, we present the treatment of a fusion tooth by combining 3D printing technology and endodontic intervention in a 10-year-old patient. The bifid crown of a maxillary right lateral incisor #7 had caused esthetic concerns and malocclusion. Clinical and radiographic examinations showed that #7 is fused with a supernumerary tooth with 2 independent root canals. The fusion involved the entire crown and the coronal and middle roots. Because of financial constraints, a multidisciplinary approach involving endodontic, orthodontic, and prosthodontic treatment was excluded. We hemisectioned the tooth intraorally with a 3D-printed guide, extracted the supernumerary tooth, and transplanted tooth #7 to a position with improved esthetics and occlusion. A 3D-printed tooth replica was used to prepare the recipient site for autotransplantation. At the 6-month follow-up, tooth #7 was diagnosed with pulp necrosis and asymptomatic apical periodontitis. Root canal treatment of tooth #7 was completed, and osseous healing was observed 8 months later. The patient had no clinical symptoms and was satisfied with the outcome 14 months after hemisection and transplantation. The open space between teeth #7 and #8 was closed without orthodontic treatment. We present an alternative option to treat a fusion tooth in young patients who do not opt for other treatment options because of their stage of development or for socio-economic reasons. Techniques in modern endodontics, such as cone-beam computed tomographic imaging and 3D printing, should be adapted when it is beneficial to patients.
三维（3D）打印导板已用于牙髓学，以预备保守的进入路径、定位钙化或缺失的根管，并在根尖切除术中进行精确的截骨术。在这里，我们介绍了一种结合 3D 打印技术和牙髓干预治疗 10 岁患者融合牙的方法。右上侧门牙#7 的分叉冠引起了美观和咬合问题。临床和影像学检查显示，#7 与一颗额外牙融合，有 2 个独立的根管。融合涉及整个冠部和冠根及中根。由于经济限制，排除了涉及牙髓、正畸和修复治疗的多学科方法。我们通过 3D 打印导板在口内半切牙，拔除额外牙，并将#7 移植到改善美观和咬合的位置。使用 3D 打印牙复制体预备自体移植的受植区。6 个月随访时，#7 诊断为牙髓坏死和无症状根尖周炎。完成了#7 的根管治疗，8 个月后观察到骨愈合。患者无临床症状，14 个月后半切和移植后对结果满意。#7 和#8 之间的间隙在没有正畸治疗的情况下关闭。我们为不选择其他治疗方案的年轻患者提供了一种替代方案，这些患者因发育阶段或社会经济原因而不选择其他治疗方案。在有利于患者的情况下，应采用现代牙髓学技术，如锥形束计算机断层扫描成像和 3D 打印。
