Maity Ipsita, Das Lovely, Mazumdar Paromita, Ghosh Kushal Kumar
Department of Conservative Dentistry and Endodontics, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India.
J Conserv Dent Endod. 2025 Jan;28(1):101-105. doi: 10.4103/JCDE.JCDE_433_24. Epub 2025 Jan 13.
This case study delves into an uncommon occurrence of internal root resorption (IRR), an inflammatory variant with perforation of root, in the left central incisor, which seems to have a prevalence ranging from 0.01% to 1%. The patient presented with pain in the upper left front tooth, leading to a diagnosis of pulpal necrosis with symptomatic apical periodontitis. The initial phase involved identifying the three-dimensional overview of resorption and perforation using cone-beam computed tomography and nonsurgical root canal treatment utilizing orthograde mineral trioxide aggregate (MTA) placement and thermoplasticized obturation technique, aided by sonic-irrigation, and intracanal medicament under magnification. In the later phase, based on the clinical and radiographical evaluation and addressing the complexities of the perforative resorptive lesion, surgical approach needed to be performed. A 6-month follow-up revealed the arrest of IRR and a satisfactory overall outcome. This case report discusses the etiology, prevalence, clinical decision-making, and therapeutic management of IRR.
本病例研究深入探讨了左中切牙罕见的牙根内吸收(IRR)情况,这是一种伴有牙根穿孔的炎症变体,其患病率似乎在0.01%至1%之间。患者左上前牙疼痛,诊断为牙髓坏死伴症状性根尖周炎。初始阶段包括使用锥形束计算机断层扫描确定吸收和穿孔的三维概况,以及采用正向放置矿物三氧化物凝聚体(MTA)和热塑充填技术进行非手术根管治疗,辅助以声波冲洗,并在放大条件下进行根管内用药。在后期阶段,根据临床和影像学评估并应对穿孔性吸收性病变的复杂性,需要采取手术方法。6个月的随访显示牙根内吸收得到控制,总体结果令人满意。本病例报告讨论了牙根内吸收的病因、患病率、临床决策和治疗管理。