Cardoso Tarallo Alessandra Manchini, de Souza Matos Felipe, Ferreira de Souza Valdirene, Renato Paranhos Luiz, Moreira Herval Álex, Carneiro Valera Marcia, Talge Carvalho Cláudio Antonio
Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, SP, Brazil.
Dental Speciality Centre of Bragança Paulista, Bragança Paulista, SP, Brazil.
Iran Endod J. 2019 Spring;14(2):160-165. doi: 10.22037/iej.v14i2.23984.
This article presents a case of odontogenic keratocyst (OKC) located in the mandible, involving teeth 36 to 45, with significant loss of alveolar bone and aseptic pulp necrosis, emphasizing on root canal treatment after surgical intervention. Orthopantomogram and computed tomography examinations revealed an extensive, well-defined, and multilocular radiolucent lesion. Histopathological examination after incisional biopsy confirmed OKC, which was removed completely with enucleation and curettage, followed by the endodontic treatments of teeth 36 to 45 using reciprocating nickel-titanium files (Reciproc) in a single session. Afterwards, teeth 33 to 36 underwent apical surgery to create an appropriate bone development. Panoramic radiographic images showed bone formation and no sign of recurrence after one-year follow-up. In conclusion, this surgical approach, combined with the endodontic treatments of the teeth involved in the lesion, was effective for the management of OKC, promoting injury regression and preservation of the natural teeth.
本文介绍了一例位于下颌骨的牙源性角化囊肿(OKC)病例,累及36至45号牙,伴有牙槽骨大量丧失和无菌性牙髓坏死,重点阐述了手术干预后的根管治疗。全景片和计算机断层扫描检查显示一个广泛的、边界清晰的多房性透射性病变。切开活检后的组织病理学检查确诊为OKC,通过摘除和刮除术将其完全切除,随后使用往复式镍钛锉(Reciproc)在一次就诊中对36至45号牙进行根管治疗。之后,33至36号牙接受根尖手术以促进适当的骨发育。全景放射影像显示骨形成,一年随访后无复发迹象。总之,这种手术方法,结合对病变累及牙齿的根管治疗,对于牙源性角化囊肿的治疗是有效的,促进了损伤的消退并保留了天然牙。