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外伤未成熟恒切牙的外部炎性根吸收:MTA 充填还是牙髓再生?病例系列

External Inflammatory Root Resorption in Traumatized Immature Incisors: MTA Plug or Revitalization? A Case Series.

作者信息

Boukpessi Tchilalo, Cottreel Leslie, Galler Kerstin M

机构信息

Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, University Paris Cité, 1 rue Maurcice Arnoux, 92120 Montrouge, France.

Pitié Salpétrière Hospital Assistance Publique-Hôpitaux de Paris, 75013 Paris, France.

出版信息

Children (Basel). 2023 Jul 18;10(7):1236. doi: 10.3390/children10071236.

Abstract

INTRODUCTION

External inflammatory root resorption (EIRR) in immature permanent teeth is a common complication after severe dental trauma. The management of this condition requires thorough disinfection of the root canal in order to arrest the resorptive process. However, current guidelines regarding the recommended treatment of EIRR following traumatic dental injuries vary, mainly in regard to the type of intracanal medication and its retention time in the root canal system. The objective of this case series was to present both the apical barrier technique (MTA plug) and revitalization procedures as valid treatment options in immature teeth with EIRR.

METHODS

Four cases of post-traumatic immature teeth diagnosed with pulp necrosis and EIRR, with or without apical periodontitis, were treated either by an MTA plug (two teeth) or revitalization (two teeth). Cases were followed between 12 and 24 months.

RESULTS

Both treatment methods were efficient in arresting EIRR and enabled bone healing. After revitalization, partial root maturation was observed.

CONCLUSION

Whereas the key to achieve periodontal healing in cases of EIRR is thorough disinfection of the root canal, both a subsequent MTA plug as well as revitalization may represent adequate treatment methods. An additional benefit lies in the potential of revitalization to promote further root maturation through hard tissue apposition.

摘要

引言

年轻恒牙的外部炎性根吸收(EIRR)是严重牙外伤后的常见并发症。这种情况的处理需要对根管进行彻底消毒,以阻止吸收过程。然而,目前关于牙外伤后EIRR推荐治疗方法的指南各不相同,主要体现在根管内用药的类型及其在根管系统中的保留时间方面。本病例系列的目的是介绍根尖屏障技术(MTA充填)和再生活化程序作为EIRR年轻恒牙的有效治疗选择。

方法

4例诊断为牙髓坏死和EIRR的外伤后年轻恒牙,伴或不伴有根尖周炎,分别采用MTA充填(2颗牙)或再生活化(2颗牙)进行治疗。对病例进行了12至24个月的随访。

结果

两种治疗方法在阻止EIRR和促进骨愈合方面均有效。再生活化后,观察到牙根部分成熟。

结论

虽然在EIRR病例中实现牙周愈合的关键是对根管进行彻底消毒,但随后的MTA充填以及再生活化都可能是合适的治疗方法。再生活化的另一个好处在于它有可能通过硬组织附着促进牙根进一步成熟。

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