Rodriguez Pablo Alejandro, Chaintiou Piorno Romina, Consoli Lizzi Eugenia Pilar
Department of Endodontics, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
J Med Cases. 2022 Sep;13(9):456-461. doi: 10.14740/jmc3982. Epub 2022 Sep 28.
A case report is presented, in which a tooth with a chronic apical abscess that has caused a maxillary sinusitis was treated with an endodontic microsurgery. A 65-year-old female patient reported discomfort in a maxillary tooth gingiva. Clinically, a dental metal-ceramic bridge with adequate marginal adaptation, involving teeth from maxillary right canine to maxillary right second molar, was observed. The periapical radiograph showed the adequate adaptation of the crown and post in the maxillary right first premolar, an apical lesion, and the heavy thickening of the maxillary sinus floor mucosa. The diagnosis established in the maxillary right first premolar was of a previously treated tooth and a chronic apical abscess. Considering the accurate fixed prosthesis adaptation and the impossibility of disassembling the five-piece-metal-ceramic bridge to perform a new endodontic treatment and the prosthetic restoration, an endodontic microsurgery of this tooth was performed. The post-treatment follow-up of 12-month recall showed a normal thickness sinus membrane and a regenerating cortical bone. The proposed microsurgery has enabled the maintenance of the existing prosthetic rehabilitation of the tooth that caused the sinus pathosis.
本文报告了一例病例，其中一颗患有慢性根尖脓肿并引发上颌窦炎的牙齿通过牙髓显微外科手术进行了治疗。一名65岁女性患者报告上颌牙齿牙龈不适。临床检查发现，有一个边缘密合良好的金属烤瓷桥，涉及上颌右侧尖牙至上颌右侧第二磨牙。根尖X线片显示上颌右侧第一前磨牙的冠和桩密合良好，有根尖病变，且上颌窦底黏膜明显增厚。上颌右侧第一前磨牙的诊断为曾接受过治疗的牙齿及慢性根尖脓肿。考虑到固定修复体密合良好，且无法拆除五单位金属烤瓷桥来进行新的牙髓治疗和修复，遂对该牙齿进行了牙髓显微外科手术。术后12个月的随访显示，窦膜厚度正常，皮质骨再生。所提议的显微外科手术使得导致鼻窦病变的患牙得以维持现有的修复状态。
