Chan Alex Simon, Chan Andrew Jonathan, Chan Ambrose, Armati Patricia
Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.
Photobiomodul Photomed Laser Surg. 2024 Jun;42(7):488-492. doi: 10.1089/photob.2023.0197. Epub 2024 May 3.
Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm, 30 sec). The total time from extraction to replantation was 14 min 35 sec. The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.
意向性再植（IR）是一种新兴的、具有成本效益的治疗持续性根尖周炎的最后手段。用于IR的辅助光疗旨在通过加强消毒、刺激愈合和促进再生来改善对具有挑战性病例的管理。我们报告了一项在一名68岁糖尿病男性的一颗患有广泛根尖周感染（Ø>10mm）的受损侧切牙上进行的新型光疗辅助IR方案。IR方案包括术前和术后光生物调节（660nm，0.2J/cm，60秒/部位）、根面抗菌光动力治疗（660nm，0.6J/cm，30秒，亚甲蓝光敏剂）以及Er:YAG牙根和牙槽清创（2940nm，21J/cm，30秒）。从拔牙到再植的总时间为14分35秒。在3.5年的随访中，该牙齿保持临床功能，感染的影像学表现消退，表明再植成功。本病例报告表明，辅助光疗IR方案可有效治疗患有广泛根尖周感染的受损牙齿。
