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下颌第一磨牙近中根复杂根管弯曲的处理:一例报告及文献综述

Management of Radix Entomolaris of Mandibular First Molar With Complex Root Canal Curvatures: A Case Report and Mini Review.

作者信息

Chamani Ali, Gharechahi Maryam, Shakiba Reza, Alipour Farshad

机构信息

Department of Endodontics School of Dentistry, Mashhad University of Medical Sciences Mashhad Iran.

Associate Professor of Endodontics, Department of Endodontics School of Dentistry, Mashhad University of Medical Sciences Mashhad Iran.

出版信息

Clin Case Rep. 2025 Jan 20;13(1):e70104. doi: 10.1002/ccr3.70104. eCollection 2025 Jan.

Abstract

Radix entomolaris (RE) characterized by an extra root in mandibular molars is a rare phenotype. When this condition coincides with complex root canal curvatures or S-shaped canals, root canal therapy (RCT) challenges arise. The present study presents three cases of RE along with complex root curvatures. The challenges of RCT and case management in this study are addressed within the framework of paying attention to the access cavity according to the extra root, instrumentation with the crown-down technique, sufficient irrigation, using nickel-titanium rotary systems, dense obturation with the warm vertical technique, and patient follow-up. Also, in the last case, the management of two broken files by loop and bypass techniques is described. Adequate knowledge of the root canal system's morphology and the use of appropriate techniques and materials for root canal therapy are the background for successful RCT.

摘要

根下磨牙(RE)的特征是下颌磨牙有额外的牙根,这是一种罕见的表型。当这种情况与复杂的根管弯曲或S形根管同时出现时,根管治疗(RCT)就会面临挑战。本研究展示了三例伴有复杂牙根弯曲的RE病例。本研究中RCT的挑战和病例管理在以下框架内进行阐述:根据额外牙根关注开髓腔、采用冠向下技术进行器械操作、充分冲洗、使用镍钛旋转系统、采用热垂直加压技术进行致密充填以及对患者进行随访。此外,在最后一个病例中,描述了通过套圈和旁路技术处理两根折断锉的方法。对根管系统形态的充分了解以及使用适当的技术和材料进行根管治疗是成功进行RCT的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52f3/11747136/ada5c5ec523c/CCR3-13-e70104-g002.jpg

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