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颌间固定（IMF）螺钉置入导致牙根穿孔的牙髓病学及外科治疗：一例报告

Endodontic and Surgical Management of Root Perforation Caused by Intermaxillary Fixation (IMF) Screw Placement: A Case Report.

作者信息

Alhumaid Mohammed, Alkhairallah Yousra, Altokheus Abdullmajeed, Alzahrani Lama A, Altahtam Abdulaziz

机构信息

Endodontics, Prince Sultan Military Medical City, Riyadh, SAU.

General Dentistry, Prince Sultan Military Medical City, Riyadh, SAU.

出版信息

Cureus. 2024 Oct 17;16(10):e71716. doi: 10.7759/cureus.71716. eCollection 2024 Oct.

DOI:10.7759/cureus.71716
PMID:39552955
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568835/
Abstract

The use of fixation screws is a valuable tool in the clinical practice of oral and maxillofacial surgeries. One potential complication of screw placement for fracture fixation is root damage during surgery. In some cases, this damage can further lead to irreversible pulp damage, which requires endodontic and/or surgical intervention. The present report describes a case of iatrogenic root perforation during intermaxillary fixation (IMF) screw placement, leading to pulp necrosis. Despite the complication, the root damage was effectively managed through non-surgical root canal treatment using calcium silicate root filling material, followed by surgical apicectomy and retrograde fill. The patient was asymptomatic at a nine-month follow-up, and radiographic examinations showed signs of initial bone healing at the surgical site. After the successful management of the root perforation, the patient was referred to the prosthodontics department for the placement of the final restoration. It is important to understand the potential damage that may occur with screw-root contact and how it can be avoided or minimized. This report highlights the challenges and considerations in managing such cases and emphasizes the importance of using IMF screws with caution and the need for regular follow-ups in instances where tooth root damage has been confirmed.

摘要

固定螺钉的使用是口腔颌面外科临床实践中的一项重要工具。骨折固定时螺钉植入的一个潜在并发症是手术过程中牙根损伤。在某些情况下，这种损伤可能进一步导致不可逆的牙髓损伤，这需要进行牙髓治疗和/或手术干预。本报告描述了一例在颌间固定（IMF）螺钉植入过程中发生医源性牙根穿孔，导致牙髓坏死的病例。尽管出现了并发症，但通过使用硅酸钙根充材料进行非手术根管治疗，随后进行根尖切除术和倒充填，有效地处理了牙根损伤。在9个月的随访中，患者无症状，影像学检查显示手术部位有初步骨愈合迹象。在成功处理牙根穿孔后，患者被转至口腔修复科进行最终修复体的植入。了解螺钉与牙根接触可能发生的潜在损伤以及如何避免或最小化这种损伤非常重要。本报告强调了处理此类病例的挑战和注意事项，并强调了谨慎使用IMF螺钉的重要性以及在确认牙根损伤的情况下进行定期随访的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/8e5facb9e6a9/cureus-0016-00000071716-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/d0803cf1e1d9/cureus-0016-00000071716-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/c5ae11079eae/cureus-0016-00000071716-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/068c97742a66/cureus-0016-00000071716-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/f65349cc51a7/cureus-0016-00000071716-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/079a91db801a/cureus-0016-00000071716-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/ba176365d590/cureus-0016-00000071716-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/b4c89625b14e/cureus-0016-00000071716-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/402402fbcbaa/cureus-0016-00000071716-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/0681884c16cf/cureus-0016-00000071716-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/eed686908301/cureus-0016-00000071716-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/8e5facb9e6a9/cureus-0016-00000071716-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/d0803cf1e1d9/cureus-0016-00000071716-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/c5ae11079eae/cureus-0016-00000071716-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/068c97742a66/cureus-0016-00000071716-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/f65349cc51a7/cureus-0016-00000071716-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/079a91db801a/cureus-0016-00000071716-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/ba176365d590/cureus-0016-00000071716-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/b4c89625b14e/cureus-0016-00000071716-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/402402fbcbaa/cureus-0016-00000071716-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/0681884c16cf/cureus-0016-00000071716-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/eed686908301/cureus-0016-00000071716-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/11568835/8e5facb9e6a9/cureus-0016-00000071716-i11.jpg

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