Hashem Qamar
Conservative Dentistry Department, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.
Case Rep Dent. 2025 Apr 22;2025:7225338. doi: 10.1155/crid/7225338. eCollection 2025.
The pathogenic process of through-and-through lesions leads to erosion and loss of both cortical plates. Endodontic microsurgery (MS)with bone graft and membrane placement (guided tissue regeneration (GTR)) is the proposed treatment for such cases. This article is aimed at discussing an unusual treatment protocol for a large through-and-through lesion without the use of bone grafting or membrane. A 26-year-old Air Force pilot traveling at high altitudes presented to the Endodontic division for management of pain and swelling related to the upper left anterior lesion concerning Teeth #21, #22, and #23. Following a thorough clinical examination, medical history, and clinical and radiographic examination, the diagnosis of the presence of a through-and-through lesion related to previously treated teeth. The treatment plan included endodontic MS without the use of GTR due to his work nature. Over 3 years, routine follow-ups were essential for tracking the damaged area's healing process, which ultimately resulted in full recovery. This case emphasizes how crucial it is to obtain a thorough history and use a multidisciplinary approach to diagnose and manage through-and-through lesions, achieving positive outcomes.
贯通性病变的致病过程会导致两层皮质板均发生侵蚀和缺失。根管显微外科手术（MS）联合植骨及放置屏障膜（引导组织再生术（GTR））是针对此类病例的推荐治疗方法。本文旨在探讨一种针对大型贯通性病变的特殊治疗方案，该方案不使用植骨或屏障膜。一名26岁的空军飞行员在高海拔地区飞行后，因与左上前方与21、22和23号牙相关的病变有关的疼痛和肿胀而就诊于牙髓科。经过全面的临床检查、病史询问以及临床和影像学检查，诊断为存在与先前治疗过的牙齿相关的贯通性病变。由于其工作性质，治疗计划包括不使用GTR的根管显微外科手术。在3年多的时间里，定期随访对于追踪受损区域的愈合过程至关重要，最终实现了完全康复。该病例强调了获取详尽病史并采用多学科方法来诊断和处理贯通性病变以取得积极结果的重要性。
