Aminsobhani Mohsen, HafeziMotlagh Kimia, MahjourianQomi Reza
Department of Endodontics Dental Research Center AJA and Tehran University of Medical Sciences Tehran Iran.
Department of Oral Medicine School of Dentistry Tehran University of Medical Sciences Tehran Iran.
Clin Case Rep. 2023 Sep 10;11(9):e7905. doi: 10.1002/ccr3.7905. eCollection 2023 Sep.
With today's increasing desire to preserve natural teeth, managing teeth with a poor prognosis is a new challenge for clinicians. A dentist's attention to patient-centered care is essential, which improves dental outcomes.
Nowadays, patients' interest in preserving their natural teeth has increased. In the patient-centered care model, the clinician should consider the patient's preferences and values in the treatment plan. This strengthens the patient's responsibility toward his own body, resulting in more patient satisfaction and effective cooperation. Therefore, the skill of saving teeth with a poor prognosis, in which there was no other choice but to extract them, becomes essential in patients who want to preserve their natural teeth. This case report presents the successful 18-year treatment and management of a maxillary central incisor of a 17-year-old male with a horizontal root fracture, who was incompletely treated in another medical center when the trauma occurred. The patient presented to us after 6 months. Due to the short length of the root, the patient underwent regenerative endodontic treatment first, but he did not attend follow-ups. Finally, after 8 years, the patient returned with symptoms of infection and periapical radiolucency. The apical part of the root was resorbed during this time. Finally, it was decided to place an apical plug with MTA. MTA was extruded from the apical part of the root canal during the placement of the apical plug. In the 1-, 2-, 4-, and 10-year follow-ups, the patient was completely asymptomatic, and the radiolucent periradicular lesion had healed. However, the extruded MTA was still present in the radiographic images without interfering with the healing process. Finally, the tooth has remained functional for 18 years.
随着如今人们对保留天然牙的需求日益增加，对预后不良的牙齿进行管理对临床医生来说是一项新挑战。牙医关注以患者为中心的护理至关重要，这能改善牙科治疗效果。
如今，患者对保留天然牙的兴趣有所增加。在以患者为中心的护理模式中，临床医生应在治疗方案中考虑患者的偏好和价值观。这增强了患者对自身身体的责任感，从而带来更高的患者满意度和更有效的合作。因此，对于想要保留天然牙的患者而言，挽救预后不良的牙齿（以往除了拔除别无他法）的技能变得至关重要。本病例报告介绍了一名17岁男性上颌中切牙水平根折的18年成功治疗与管理情况，该患者在创伤发生时于另一家医疗中心接受了不完整治疗。患者在6个月后前来就诊。由于牙根较短，患者首先接受了根尖诱导成形术治疗，但未进行随访。最终，8年后患者因感染症状和根尖周透射区再次前来。在此期间牙根尖部发生了吸收。最终决定用MTA放置根尖屏障。在放置根尖屏障时MTA从根管根尖部挤出。在1年随访、2年随访、4年随访和10年随访中，患者完全无症状，根尖周透射性病变已愈合。然而，挤出的MTA在影像学图像中仍然存在，并未干扰愈合过程。最终，这颗牙齿保持功能达18年。
