Chamani Ali, Zarei Mina, Soltaninezhad Pouria, Jamali Seyyedeh Zahra, Sadeghnezhad Pegah
Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Private Practice, Mashhad, Iran.
Iran Endod J. 2025;20(1):e12. doi: 10.22037/iej.v20i1.46598. Epub 2025 Jan 26.
Taurodontism is a dental anomaly characterized by the absence of cervical constriction at the cemento-enamel junction, apical shifting of the pulpal floor, and an expanded pulp chamber. This condition presents unique challenges in endodontic diagnosis and treatment due to its variable morphology, deeply located orifices, and complex root canal system. This paper reports three cases of hypertaurodontism (Taurodont Index ≈ 50), including a maxillary first molar, mandibular third molar, and mandibular second premolar in systemically healthy patients. The identification and treatment planning were facilitated by cone-beam computed tomography (CBCT). Root canal therapy was performed under a dental operating microscope, with careful exploration, chemomechanical instrumentation using rotary files, copious irrigation with 5.25% sodium hypochlorite, and warm vertical obturation. Twelve months later, follow-up visits showed that all patients were clinically and radiographically asymptomatic, indicating successful outcomes. Taurodontism presents significant challenges due to its anatomical complexities. A multifaceted approach involving CBCT, dental operating microscopes, ultrasonic irrigation, and warm vertical obturation is recommended. This case series demonstrates that with advanced diagnostic aids and meticulous techniques, even hypertaurodontic teeth can be effectively managed.
牛牙样变是一种牙齿发育异常，其特征为在牙骨质-釉质界处缺乏颈部缩窄、髓室底向根尖移位以及髓腔扩大。由于其形态多变、根管口位置深以及根管系统复杂，这种情况在牙髓病诊断和治疗中带来了独特的挑战。本文报告了3例巨牛牙样变病例（牛牙样变指数≈50），包括1例上颌第一磨牙、1例下颌第三磨牙和1例下颌第二前磨牙，患者全身健康。锥形束计算机断层扫描（CBCT）有助于进行识别和治疗计划制定。在牙科手术显微镜下进行根管治疗，仔细探查，使用旋转锉进行化学机械预备，用5.25%次氯酸钠大量冲洗，并进行热垂直充填。12个月后，随访显示所有患者在临床和影像学上均无症状，表明治疗结果成功。由于其解剖结构复杂，牛牙样变带来了重大挑战。建议采用包括CBCT、牙科手术显微镜、超声冲洗和热垂直充填在内的多方面方法。该病例系列表明，借助先进的诊断辅助工具和精细的技术，即使是巨牛牙样变的牙齿也能得到有效处理。
