Zhang Jing, Li Na, Li Wu-Li, Zheng Xian-Yu, Li Song
Stomatological Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, Anhui Province, China.
World J Clin Cases. 2022 Jun 26;10(18):6261-6268. doi: 10.12998/wjcc.v10.i18.6261.
Type Ⅲb dens invaginatus (DI) with a lateral canal located at the mid-third of the root is rarely reported. Here, we report a rare case of type Ⅲb DI in the left upper anterior tooth with a lateral canal that led to persistent periodontitis.
A 15-year-old female patient presented with a chief complaint of pain associated with recurrent labial swelling in the area of the left anterior tooth. A diagnosis of type Ⅲb DI and chronic periodontitis was made. Intentional replantation was performed after conventional endodontic treatment failed. After 6 mo, the patient was asymptomatic, but a sinus tract was observed. Cone-beam computed tomography images showed bone loss in the mesial of the mid-root. Based on methylene blue staining and microscopy images, the lateral foramen located at the middle third of the root was surgically treated. After 3 years of follow-up, the clinical findings and radiographic assessment presented a favorable prognosis of bone healing without root absorption or ankylosis.
Type Ⅲb DI with a lateral canal can be successfully treated by root canal treatment, intentional replantation, and surgical therapy.
根中1/3处有侧支根管的Ⅲb型牙内陷（DI）鲜有报道。在此我们报告1例左上前牙Ⅲb型DI伴侧支根管导致慢性牙周炎的罕见病例。
一名15岁女性患者，主诉左前牙区反复唇侧肿胀伴疼痛。诊断为Ⅲb型DI和慢性牙周炎。常规根管治疗失败后行意向性再植。6个月后，患者无症状，但发现有窦道。锥形束计算机断层扫描图像显示根中1/3近中骨质吸收。根据亚甲蓝染色和显微镜图像，对位于根中1/3的侧支根管进行了手术治疗。经过3年随访，临床检查和影像学评估显示骨愈合预后良好，无牙根吸收或牙根粘连。
伴有侧支根管的Ⅲb型DI可通过根管治疗、意向性再植和手术治疗成功治愈。
