Asgary Saeed, Parhizkar Ardavan, Samiei Mohammad
Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, 1983963113 Tehran, Iran.
J Clin Pediatr Dent. 2022 Nov;46(6):45-49. doi: 10.22514/jocpd.2022.025. Epub 2022 Nov 1.
Regenerative endodontic treatment (RET) has been considered a successful approach to manage infected immature teeth; however, cases associated with dental anomalies, talon cusp, need to be further investigated.
A 7-year-old girl with local swelling associated with the permanent maxillary right central incisor was referred; cone-beam computed tomography revealed a talon cusp, an immature root and two well-defined endodontic lesions. The treatment consisted of regenerative endodontic treatment (RET); the canal was chemically cleaned and a modified triple antibiotic paste was used as intracanal medication. In the next appointment, RET was performed through the creation of blood clot scaffold in the canal covered/sealed with calcium-enriched mixture (CEM) cement.
In the 7-day recall session, clinical examination showed that the swelling had completely resolved. At 24-month recall, the treated tooth was asymptomatic and functional. CBCT images demonstrated evidence of maturation in the apical third of the root, healing of two large endodontic lesions and complete dentinal bridge formation beneath CEM cement.
RET for an infected immature tooth with a dental anomaly, talon cusp, may be a desirable treatment option and result in the resolution of endodontic lesions as well as regeneration of new vital tissues; allowing continuous root maturation.
再生性牙髓治疗（RET）已被认为是处理感染的未成熟恒牙的一种成功方法；然而，与牙齿异常相关的病例，如畸形中央尖，仍需进一步研究。
一名7岁女童因上颌右侧恒中切牙局部肿胀前来就诊；锥形束计算机断层扫描显示有一个畸形中央尖、牙根未成熟以及两个边界清晰的牙髓病变。治疗采用再生性牙髓治疗（RET）；根管进行化学清理，并使用改良的三联抗生素糊剂作为根管内用药。在下次复诊时，通过在根管内形成血凝块支架并用富钙混合物（CEM）水泥覆盖/封闭来进行RET。
在7天的复诊时，临床检查显示肿胀已完全消退。在24个月的复诊时，治疗后的牙齿无症状且功能正常。锥形束计算机断层扫描（CBCT）图像显示牙根根尖三分之一处有成熟迹象，两个大的牙髓病变愈合，且在CEM水泥下方形成了完整的牙本质桥。
对于伴有牙齿异常（畸形中央尖）的感染未成熟恒牙，RET可能是一种理想的治疗选择，可使牙髓病变得到解决，并使新的有活力组织再生；促进牙根持续发育成熟。
