Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, AlMajmaah, Saudi Arabia.
Niger J Clin Pract. 2021 Jul;24(7):1092-1095. doi: 10.4103/njcp.njcp_473_20.
Root canal therapy in teeth with root fenestrations can present with pain on apical palpation or persistent pain. The signs and symptoms of root fenestration in the absence of mucosal fenestration may be misleading, which may be misdiagnosed as non-odontogenic pain. Although CBCT is superior to periapical radiographs for the diagnosis of root fenestration, it failed to detect the intact cortical plate in the middle third in our cases. Therefore, the type was different in CBCT from its actual size surgically. Repeated non-surgical root canal treatment would not alleviate pain in the presence of root fenestration and may lead to apical root fracture. Root-resection relieves pain, unless the fenestration is accompanied by fracture. The aim of these two case reports was to describe the diagnosis and treatment of endodontically treated teeth with a persistent pain. Also, the difference of root fenestration type between CBCT and its actual size was described.
根管治疗后出现根尖触痛或持续性疼痛的牙齿可能存在根管侧穿。无黏膜侧穿的根管侧穿的体征和症状可能具有误导性，可能被误诊为非牙源性疼痛。虽然 CBCT 比根尖片更有助于根管侧穿的诊断，但在我们的病例中，它未能检测到中三分之一的完整皮质板。因此，CBCT 上的类型与实际手术大小不同。在存在根管侧穿的情况下，反复进行非手术根管治疗不会缓解疼痛，并且可能导致根尖根折。根管切除可缓解疼痛，除非侧穿伴有骨折。这两个病例报告的目的是描述根管治疗后持续性疼痛牙齿的诊断和治疗。还描述了 CBCT 上的根管侧穿类型与实际大小之间的差异。
