使用锥形束计算机断层扫描作为术中资源对重度钙化牙齿进行根管治疗

Root Canal Treatment of Severely Calcified Teeth with Use of Cone-Beam Computed Tomography as an Intraoperative Resource.

作者信息

Quaresma Sérgio André, da Costa Rui Pereira, Ferreira Petean Igor Bassi, Silva-Sousa Alice Corrêa, Mazzi-Chaves Jardel Francisco, Ginjeira António, Sousa-Neto Manoel Damiâo

机构信息

Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Department of Endodontics, Faculdade de Medicina Dentaria, Universidade de Lisboa, Lisbon, Portugal.

出版信息

Iran Endod J. 2022 Winter;17(1):39-47. doi: 10.22037/iej.v17i1.36153.

Abstract

The aim of this study was to describe a new strategy, consisting of the use of cone-beam computed tomography (CBCT) in the planning and intraoperative stages of root canal treatment (RCT), associated with the use of radiopaque gutta-percha markers, as an auxiliary tool in the location of severely calcified root canals. Three cases involving anterior and posterior teeth with severe calcification of the root canal were submitted to initial periapical radiographic and CBCT evaluations for diagnosis and planning of the operative steps. In a first intervention, when the location of the canal orifice was not successful, radiopaque markers were inserted in the suggested position of canal orifice with the aid of magnification and the use of ultrasonic devices, in order to perform an intraoperative CBCT analysis that allowed dynamic navigation through the static position of markers. The association of intraoperative CBCT with radiopaque markers allowed the location of the canal orifice and the following RCT execution. The use of CBCT in two different moments of RCT allowed the diagnosis of three-dimensional anatomical variations of root canal. Add, when associated with the use of radiopaque gutta-percha markers, acted as an auxiliary tool in the location of the canal orifice of calcified canals. Therefore, the presented strategy provides the clinician the precision that cases with calcification require and give an important contribution to treatment predictability.

摘要

本研究的目的是描述一种新策略,该策略包括在根管治疗(RCT)的计划和术中阶段使用锥束计算机断层扫描(CBCT),并结合使用不透射线的牙胶尖标记物,作为定位严重钙化根管的辅助工具。对3例涉及根管严重钙化的前牙和后牙病例进行了初步根尖片和CBCT评估,以诊断和规划手术步骤。在第一次干预中,当根管口定位不成功时,在放大设备和超声设备的辅助下,将不透射线的标记物插入根管口的建议位置,以便进行术中CBCT分析,从而通过标记物的静态位置进行动态导航。术中CBCT与不透射线标记物的联合使用使得根管口得以定位,并随后进行了RCT。在RCT的两个不同阶段使用CBCT能够诊断根管的三维解剖变异。此外,当与不透射线的牙胶尖标记物联合使用时,它可作为定位钙化根管根管口的辅助工具。因此,所提出的策略为临床医生提供了钙化病例所需的精确性,并对治疗的可预测性做出了重要贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/678c/9868984/b62e5544ec9d/IEJ-17-39-g001.jpg

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