Bolhari Behnam, Noori Faranak, Assadian Hadi
Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Front Dent. 2021 Nov 27;18:42. doi: 10.18502/fid.v18i42.8014. eCollection 2021.
Dens invagination (DI) is a dental anomaly that can cause pulpal and periapical pathoses of the affected tooth. We describe the treatment of a healthy 18-year-old female with a chief complaint of recurrent facial swelling pertaining to a peg-shaped maxillary lateral incisor with DI. Examinations showed necrosis of the involved tooth with symptomatic apical periodontitis. Cone-beam computed tomography corresponded to Oehlers type II DI. Orthograde endodontic treatment was performed. To completely debride the canal and resolve the persistent purulent discharge, various methods and medicaments were used in separate sessions including passive ultrasonic activation of 5.25% sodium hypochlorite solution, calcium hydroxide mixed with 2% chlorhexidine, and double antibiotic paste as intracanal medicament. After resolution of the symptoms, the root canal and the invaginated space were filled by a mineral trioxide aggregate plug and backfilled with thermoplasticized gutta-percha. At the one-year follow-up, complete bone healing was noted in the affected periradicular area.
牙内陷（DI）是一种可导致患牙牙髓和根尖周病变的牙齿异常。我们描述了一名18岁健康女性的治疗情况，其主要诉求为与一颗患有牙内陷的钉状上颌侧切牙相关的反复面部肿胀。检查显示患牙坏死并伴有症状性根尖周炎。锥形束计算机断层扫描结果符合奥勒斯II型牙内陷。进行了常规根管治疗。为了彻底清理根管并解决持续的脓性分泌物问题，在不同阶段使用了多种方法和药物，包括5.25%次氯酸钠溶液的被动超声激活、氢氧化钙与2%洗必泰混合、以及双抗生素糊剂作为根管内药物。症状缓解后，用三氧化矿物凝聚体堵塞根管和内陷空间，并用热塑牙胶回填。在一年的随访中，观察到患牙根尖周区域完全骨愈合。
