Liao Ying, Pan Ting, Xing Xianghui
Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China.
Case Rep Dent. 2024 Jan 6;2024:5128588. doi: 10.1155/2024/5128588. eCollection 2024.
Pulp involvement of immature permanent teeth with dentinogenesis imperfecta is challenging and could lead to extraction. A case of dentinogenesis imperfecta-induced periapical periodontitis of an immature permanent tooth was treated with regenerative endodontic treatment (RET), and root maturation was observed in 12-month follow-up. An 8-year-old girl presented acute pain and swelling in central mandibular region. Clinical and radiographic examination revealed "shell teeth" appearance of teeth 31, 41, and 42. Periapical lesion of tooth 31 was observed. Tooth 41 was previously treated with apexification. RET was planned and carried out for the necrotic tooth (tooth 31) with dentinogenesis imperfecta. The 1-, 3-, 7-, and 12-month postoperative recall revealed complete healing of periapical lesions. Root maturation characterized by elongation of root, thickening of dentinal walls, and closure of root apex was observed with radiographic examinations. We show that RET could be a desirable treatment for necrotic immature permanent teeth with dentinogenesis imperfecta and lead to resolution of endodontic lesions as well as maturation of dental root. The findings of this case suggest that RET should be considered by endodontist and pediatric dentist to treat teeth with similar dental anomalies and apical periodontitis.
患有牙本质发育不全的年轻恒牙牙髓受累情况具有挑战性,可能导致牙齿拔除。一例牙本质发育不全引起的年轻恒牙根尖周炎采用牙髓再生治疗(RET)进行治疗,并在12个月的随访中观察到牙根成熟。一名8岁女孩下颌中部区域出现急性疼痛和肿胀。临床和影像学检查显示31、41和42号牙呈“壳牙”外观。观察到31号牙有根尖病变。41号牙先前已进行根尖诱导成形术。计划并对患有牙本质发育不全的坏死牙(31号牙)实施RET。术后1、3、7和12个月的复查显示根尖病变完全愈合。影像学检查观察到牙根成熟,其特征为牙根伸长、牙本质壁增厚和根尖闭合。我们表明,RET可能是治疗患有牙本质发育不全的坏死年轻恒牙的理想方法,并可导致牙髓病变的消退以及牙根的成熟。该病例的结果表明,牙髓病医生和儿童牙医应考虑采用RET来治疗具有类似牙齿异常和根尖周炎的牙齿。