de Toubes Kênia Maria Soares, Corrêa Isabella Sousa, Valadares Regina Célia Lopes, Tonelli Stephanie Quadros, Bruzinga Fábio Fernandes Borém, Silveira Frank Ferreira
Department of Dentistry, Uniube University, Uberaba, MG, Brazil.
Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil.
Int J Dent. 2024 May 9;2024:2234648. doi: 10.1155/2024/2234648. eCollection 2024.
The authors of this study proposed an innovative approach involving the use of Biodentine™ material as an intraorifice barrier in cracked teeth with root extension to promote internal crack sealing, preventing the possibility of microinfiltration and apical crack propagation.
The dental records of 11 patients with 12 posterior cracked teeth with root extension were included with a precise protocol performed by a senior endodontist. The treatment protocol included pulp diagnosis, crack identification using a dental operating microscope (DOM), endodontic treatment, placing a Biodentine™ as an intraorifice barrier, and immediate full-coverage restoration. The effectiveness of the treatment was assessed at two intervals, 6 months, and 1-3 years posttreatment, evaluating clinical, radiographic, and tomographic aspects. The treatment was deemed successful if there were no indications of radiolucency, sinus tracts, edema, or periodontal pockets associated with the crack line.
The study observed remarkably positive outcomes during the follow-up period, which spanned from 1 to 3 years. All the cracked teeth (100%) remained asymptomatic, meaning they were free of pain or discomfort. Furthermore, these teeth were in occlusal function. Both radiographic and tomographic assessments revealed the absence of bone loss along the crack line. This outcome signifies that the treatment effectively prevented further deterioration of the surrounding bone.
Integrating advanced biomaterials and conservative restorative techniques has paved the way for innovative approaches in dental care. This protocol suggests a proactive step for managing cracked teeth with root extension. It addresses both biological aspects by sealing internal cracks and mechanical aspects by preventing crack progression, thereby improving these teeth' prognosis and long-term survival.
本研究的作者提出了一种创新方法，即在牙根延伸的纵裂牙中使用BioDentine™材料作为根管口屏障，以促进内部裂缝封闭，防止微渗漏和根尖裂缝扩展。
纳入11例患者的12颗伴有牙根延伸的后牙纵裂牙的牙科记录，由一位资深牙髓病医生按照精确的方案进行操作。治疗方案包括牙髓诊断、使用牙科手术显微镜（DOM）识别裂缝、牙髓治疗、放置BioDentine™作为根管口屏障以及立即进行全冠修复。在治疗后6个月和1至3年这两个时间点评估治疗效果，评估临床、影像学和断层扫描方面。如果没有与裂缝线相关的透射区、窦道、水肿或牙周袋的迹象，则认为治疗成功。
该研究在为期1至3年的随访期间观察到了非常积极的结果。所有纵裂牙（100%）均无症状，即没有疼痛或不适。此外，这些牙齿具有咬合功能。影像学和断层扫描评估均显示裂缝线处没有骨质流失。这一结果表明治疗有效地防止了周围骨质的进一步恶化。
整合先进的生物材料和保守的修复技术为牙科护理的创新方法铺平了道路。该方案为处理伴有牙根延伸的纵裂牙提供了积极的措施。它通过封闭内部裂缝解决了生物学方面的问题，通过防止裂缝进展解决了力学方面的问题，从而改善了这些牙齿的预后和长期存活率。
