Kasperek Dariusz, Ali Rahat, Jarad Fadi
Department of Restorative Dentistry, University of Liverpool, Liverpool, United Kingdom.
Department of Restorative Dentistry, University of Liverpool, Liverpool, United Kingdom.
J Endod. 2023 Apr;49(4):445-449. doi: 10.1016/j.joen.2023.01.008. Epub 2023 Feb 2.
A patient's medical history and related dental manifestations can significantly contribute to confounding signs and symptoms leading to a diagnostic challenge. An 18-year-old female patient presented with persistent radiographic radiolucency associated with the apex of a previously treated tooth (tooth 9); asymptomatic apical periodontitis and endodontic failure were suspected. This report presents how a patient's condition of cleidocranial dysplasia had a profound effect on her dental history, which included the presence of multiple supernumerary teeth. Extensive surgical intervention during the patient's childhood was required to remove the supernumerary teeth, which resulted in an endodontic misdiagnosis in her adult life. After clinical and radiographic examination, the patient was diagnosed with a periapical scar. Periapical fibrous scars have a prevalence of between 2.5% and 12% and are a rare healing process with fibrous tissue after surgical and nonsurgical interventions. This report describes the diagnosis and pathophysiology of fibrous scars, including their risk factors and long-term monitoring approaches.
患者的病史及相关牙科表现可显著导致混淆的体征和症状，从而带来诊断挑战。一名18岁女性患者，其先前治疗过的牙齿（9号牙）根尖处存在持续的影像学透射区；怀疑为无症状性根尖周炎和根管治疗失败。本报告介绍了一名锁骨颅骨发育不全患者的病情如何对其牙科病史产生深远影响，其牙科病史包括多颗多生牙的存在。患者童年时期需要进行广泛的外科手术干预以拔除多生牙，这导致其成年后根管治疗被误诊。经过临床和影像学检查，该患者被诊断为根尖瘢痕。根尖纤维瘢痕的患病率在2.5%至12%之间，是手术和非手术干预后纤维组织罕见的愈合过程。本报告描述了纤维瘢痕的诊断和病理生理学，包括其危险因素和长期监测方法。
