Musu Davide, Bardini Giulia, Ideo Francesca, Mezzena Silvia, Cotti Elisabetta
Department of Conservative Dentistry and Endodontics, University of Cagliari, 09124 Cagliari, Italy.
Dent J (Basel). 2021 Mar 2;9(3):27. doi: 10.3390/dj9030027.
About a quarter of all oral pathologies involving the oral cavity and dental apparatus are traumatic injuries, and a substantial number of these cases are the result of sports injuries affecting adolescents and young adults. Here, we report the case of a 25-year-old healthy female referred to the department of Endodontics for the evaluation and management of teeth 1.2 and 1.1 because of a chronic apical abscess in an area involved in a sport-related dental trauma in the past. A multi-modular diagnostic assessment, comprising conventional periapical radiographs, CBCT imaging, ultrasound, and histopathologic examination, led to a final diagnosis of an apical granulomatous lesion connected to both teeth, and an associated sinus tract. During the follow-up period of three years, the patient was reviewed twice a year and showed progressive healing of the bone and absence of the sinus tract. The present report shows the challenges of diagnosing complications arising from past dental trauma. Furthermore, it is the first documented traumatic case where ultrasound examination was fruitfully used. Emphasis should be put on introducing diagnostic ultrasound for the management of both apical periodontitis and the related sinus tract.
所有涉及口腔和牙列的口腔病理学问题中,约四分之一为创伤性损伤,其中相当一部分病例是影响青少年和青年的运动损伤所致。在此,我们报告一例25岁健康女性病例,因其过去与运动相关的牙齿创伤部位出现慢性根尖脓肿,转诊至牙髓病科对1.2和1.1牙进行评估和治疗。包括传统根尖片、CBCT成像、超声和组织病理学检查在内的多模块诊断评估,最终诊断为与两颗牙齿相连的根尖肉芽肿性病变及相关窦道。在三年的随访期内,患者每年接受两次复查,骨组织逐渐愈合,窦道消失。本报告展示了诊断过去牙齿创伤引发并发症的挑战。此外,这是首例成功应用超声检查的创伤病例记录。应重视引入诊断性超声用于根尖周炎及相关窦道的治疗。