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在传统方法基础上使用更新模式对根尖周病变进行非手术治疗:病例系列

Non-surgical Management of Periapical Lesions With the Use of Newer Modalities in Adjunct to the Conventional: A Case Series.

作者信息

Kriplani Simran, Sedani Shweta, Mishra Abeer, Umre Utkarsh

机构信息

Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Mar 31;16(3):e57314. doi: 10.7759/cureus.57314. eCollection 2024 Mar.

Abstract

For endodontic therapy to be successful, the root canal space must be sterilized. This is often done using intracanal irrigants and medications. To accomplish periradicular region sterilization and healing, various intracanal medicaments and irrigation techniques have been researched for better treatment outcomes. Ozonated olive oil is the most researched and successful adjunct to other medicaments owing to its antibacterial properties. Triple antibiotic paste (TAP) (metronidazole, ciprofloxacin, and minocycline) was incorporated as an inter-appointment intracanal dressing. Currently, many newer advances are depicting synergistic effects in the elimination of persistent endodontic pathogens. Given this, in the current case series, periapical lesions were managed non-surgically for alternating weeks by the advent of triple antibiotic paste (TAP) and ozonated olive oil (O-oil) with laser activation. Irrigation and its effects were further enhanced with the use of a laser, aiming for thorough debridement and rendering the canal free of microbes. Once the patient was asymptomatic and there was no sinus drainage seen, final obturation was done. Therefore, this case series depicts that traditional root canal therapy with the use of ozonated olive oil and laser activation can non-surgically heal the lesion, leading to successful treatment outcomes. Periapical lesions in three cases have been observed; on the initial visit, all lesions were accessible, cleansed, and shaped. We administered ozonated olive oil with laser activation and a triple antibiotic paste on the following visit. In all three cases, six-month follow-ups have shown evidence of a successful course of therapy.

摘要

为使根管治疗取得成功,根管空间必须进行消毒。这通常通过使用根管内冲洗剂和药物来完成。为实现根尖周区域的消毒和愈合,人们研究了各种根管内药物和冲洗技术以获得更好的治疗效果。由于其抗菌特性,臭氧化橄榄油是研究最多且最成功的与其他药物联用的辅助剂。三联抗生素糊剂(TAP)(甲硝唑、环丙沙星和米诺环素)被用作复诊间根管内敷料。目前,许多新进展显示在消除持续性根管病原体方面具有协同作用。鉴于此情况,在本病例系列中,通过交替使用三联抗生素糊剂(TAP)和臭氧化橄榄油(O油)并结合激光激活,对根尖周病变进行了为期数周的非手术治疗。使用激光进一步增强了冲洗及其效果,旨在彻底清创并使根管无菌。一旦患者无症状且未见窦道引流,即进行最终充填。因此,本病例系列表明,使用臭氧化橄榄油和激光激活的传统根管治疗可非手术治愈病变,从而取得成功的治疗效果。观察到三例根尖周病变;在初次就诊时,所有病变均易于处理、清洁和塑形。在接下来的就诊中,我们使用激光激活的臭氧化橄榄油和三联抗生素糊剂进行治疗。在所有三例病例中,六个月的随访均显示治疗过程成功的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d238/11059846/4619b229d21f/cureus-0016-00000057314-i01.jpg

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