Candeiro George Táccio de Miranda, de Menezes Antônio Sérgio Teixeira, de Oliveira Ana Carolina Saldanha, Alves Flávio Rodrigues Ferreira
Postgraduate Program in Dental Sciences, University Center Christus, Fortaleza, CE, Brazil.
Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
Restor Dent Endod. 2023 Apr 27;48(2):e17. doi: 10.5395/rde.2023.48.e17. eCollection 2023 May.
The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.
本报告描述了一例上颌侧切牙患有5个根管的奥勒斯II型牙内陷的根管治疗，这是一种极为罕见的情况。观察到根尖周炎及相关症状。使用锥形束计算机断层扫描辅助诊断、揭示牙齿形态并协助确定根管位置。小心进入髓腔，并在放大条件下探查根管。所有根管均使用R25 Reciproc Blue系统和次氯酸钠（NaOCl）冲洗进行预备。初始预备后，使用含NaOCl和乙二胺四乙酸的自调式锉（SAF）补充消毒。此外，还应用了氢氧化钙药物。采用垂直加压法用硅酸钙类根管封闭剂和牙胶充填根管。12个月后，患者根尖区愈合，无症状，牙齿功能正常。总之，这种非手术治疗方案成功促进了根尖周炎的治愈。在为解剖结构非常复杂的牙内陷选择最佳治疗方法时，应考虑使用SAF进行补充消毒以及应用氢氧化钙药物。
