Teh Lay Ann
Restorative Dentistry, National University of Malaysia, Kuala Lumpur, MYS.
Cureus. 2023 Jul 1;15(7):e41250. doi: 10.7759/cureus.41250. eCollection 2023 Jul.
Extrusion of root filling material had been shown to reduce the success of endodontic treatment. This case report describes the management of a patient who reported prolonged, persistent, and increasing pain on an upper root filled central incisor with extruded root filling material. A 28-year-old female patient came with the chief complaint of pain and tenderness on the upper left central incisor. The pain was mostly triggered by mastication. Upon examination and investigation, the tooth of concern was tooth 21 which was a root treated many years ago. It appeared to have tenderness on percussion and palpation. Non-surgical root canal retreatment was completed on tooth 21. However, the patient complained of the same pain while biting even after six months post-obturation. Therefore, endodontic microsurgery was performed to remove the root filling material that was extruded and to enucleate the granulomatous lesion around the periapical region of tooth 21. After enucleation, apical root end resection was performed. Postoperatively, the patient reported comfort and no pain and was able to resume her daily activities. At six months of review, the radiograph showed evidence of complete healing. This case report captured the importance of endodontic microsurgery as a viable treatment option where nonsurgical root canal retreatment failed to relieve the patient's symptoms.
根管充填材料的挤出已被证明会降低牙髓治疗的成功率。本病例报告描述了一名患者的治疗情况，该患者报告称，一颗上中切牙进行了根管充填且有充填材料挤出，出现了持续时间长、反复发作且逐渐加重的疼痛。一名28岁女性患者前来就诊，主诉左上中切牙疼痛和压痛。疼痛主要由咀嚼引发。经检查和探查，患牙为21号牙，多年前已进行过根管治疗。叩诊和触诊时该牙均有压痛。对21号牙完成了非手术根管再治疗。然而，即使在根管充填后六个月，患者仍主诉咬物时疼痛依旧。因此，进行了牙髓显微外科手术，以去除挤出的根管充填材料，并摘除21号牙根尖周区域周围的肉芽肿性病变。摘除后，进行了根尖牙根切除术。术后，患者表示舒适且无疼痛，能够恢复日常活动。在复查的六个月时，X光片显示有完全愈合的迹象。本病例报告说明了牙髓显微外科手术作为一种可行的治疗选择的重要性，当非手术根管再治疗无法缓解患者症状时，它能发挥作用。
