Taschieri Silvio, Gambarini Gianluca, Makeeva Irina, Tarasenko Svetlana, Corbella Stefano
Department of Biomedical Surgical and Dental Sciences, Università degli Studi di Milano, Italy.
Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Dent Res J (Isfahan). 2021 May 24;18:34. eCollection 2021.
The aim of the present study was to describe two clinical cases showing postoperative pain associated with the use of plastic carrier obturation system and apical bone fenestration. The patients were treated by surgical access and apicoectomy through a modern technique (using magnification and microsurgical approach), thus removing the direct contact between obturation material and submucosal connective tissue. The surgical interventions were carried on without the occurrence of any complication. Postsurgical adverse sequelae were negligible. After few weeks from the surgery, all symptoms disappeared. Radiographic healing was observed after 48 months. The presence of apical bone fenestration could be the cause of persistent pain after root canal treatment. The contact between plastic carrier and submucosal connective tissue could be the direct cause of spontaneous pain even in absence of periapical infection. Since the clinical diagnosis could be difficult, the use of tridimensional radiology could be justified. Surgical approach, by the removal of the contact between the carrier and connective tissues, can be considered a viable option to treat these particular affections.
本研究的目的是描述两例临床病例，这些病例显示术后疼痛与使用塑料载体充填系统及根尖骨开窗有关。患者通过现代技术（使用放大设备和显微手术方法）进行手术入路和根尖切除术，从而消除了充填材料与黏膜下结缔组织之间的直接接触。手术干预过程中未出现任何并发症。术后不良后遗症可忽略不计。手术后几周，所有症状均消失。48个月后观察到影像学愈合。根尖骨开窗的存在可能是根管治疗后持续性疼痛的原因。即使在没有根尖周感染的情况下，塑料载体与黏膜下结缔组织之间的接触也可能是自发疼痛的直接原因。由于临床诊断可能困难，因此使用三维放射学检查是合理的。通过消除载体与结缔组织之间的接触的手术方法，可以被认为是治疗这些特殊病症的可行选择。
