Taschieri Silvio, Corbella Stefano, Francetti Luca, Alberti Alice, Morandi Benedetta
Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan 20123, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milan 20161, Italy.
Case Rep Dent. 2023 Jul 12;2023:9180800. doi: 10.1155/2023/9180800. eCollection 2023.
This case report describes a particular application of endodontic microsurgery with a palatal approach in the presence of a radiopaque lesion inside the maxillary sinus. The patient presented complaining of pain related to the first maxillary molar and events of nasal obstruction and facial pain in the cheek and nasal area. The endodontic orthograde treatment and retreatment were done, respectively, 7 and 4 years earlier. The cone-beam computed tomography (CBCT) scan taken before the treatment showed two separate lesions: one associated with the palatine root of the molar and another one inside the maxillary sinus. The patient agreed to solve both problems in one surgical step: endodontic surgery of the palatine root with palatal access with the simultaneous asportation of a lesion from the maxillary sinus floor. Complete bone healing of the periapical area and the maxillary sinus was visualized on intra-oral radiographs, and CBCT was taken one year after the treatment. As far as the authors know, no one in literature has ever described this approach and solved in such a conservative way both the problems at the tooth and in the maxillary sinus.
本病例报告描述了在上颌窦内存在不透射线病变的情况下，采用腭侧入路进行牙髓显微外科手术的一种特殊应用。患者主诉与上颌第一磨牙相关的疼痛以及鼻塞和面颊及鼻部区域的面部疼痛症状。牙髓的常规治疗和再治疗分别在7年前和4年前进行。治疗前进行的锥形束计算机断层扫描（CBCT）显示有两个独立的病变：一个与磨牙的腭根相关，另一个在上颌窦内。患者同意在一个手术步骤中解决这两个问题：通过腭侧入路对腭根进行牙髓手术，同时从上颌窦底取出一个病变。治疗后一年拍摄的口腔内X光片显示根尖区域和上颌窦完全骨愈合，并进行了CBCT检查。据作者所知，文献中从未有人描述过这种方法，并且以如此保守的方式解决了牙齿和上颌窦的问题。
