Eskandari Fatemeh, Sahebi Safoora, Ghorbani Jahandizi Negar, Mofidi Hossein
School of Dentistry, Shiraz University of Medical Sciences, Ghasrdasht Street, 71956-15878, Shiraz, Iran.
Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
J Med Case Rep. 2025 May 1;19(1):200. doi: 10.1186/s13256-025-05148-8.
Internal root resorption is an infrequent resorption of dentin and stands among one of the endodontic challenges which comprises two types: internal replacement and inflammatory resorption. Regardless of the location, root resorption does not regress and continues to cause discomfort or sometimes tooth loss if left untreated. Internal replacement resorption is rarer compared with the other type of internal resorption. Regarding the scarcity of internal replacement resorption, the present article reports a case of endodontic management of internal replacement resorption by using NeoPutty mineral trioxide aggregate and cone-beam computed tomography to illustrate and clarify characteristics, diagnosis, possible etiologies, and treatment modalities for internal replacement resorption.
A 55-year-old Iranian man was referred for a sinus tract. Periapical radiographs revealed a periradicular lesion and cone-beam computed tomography showed the internal replacement resorption of teeth nos. 8 and 9. The root canal was explored using ultrasonic tips under magnification. Irrigation was done using 2.5% sodium hypochlorite with ultrasonic irrigation. Calcium hydroxide was placed in the root canal for 2 weeks as an intracanal medicament. At the next appointment, after calcium hydroxide removal, the root canal was dried and obturated using NeoPutty mineral trioxide aggregate. At the 2 year follow-up, the teeth were unresponsive to percussion test.
Traumatic injuries may lead to internal replacement resorption, which has a progressive nature and urges instant endodontic management. Mineral trioxide aggregate seems to be a promising material for internal replacement resorption. Besides, cone-beam computed tomography and dental operative microscopes can improve the outcome of endodontic therapy in certain challenging cases.
牙根内吸收是一种罕见的牙本质吸收，是牙髓病治疗面临的挑战之一，包括两种类型：内吸收性替代和炎症性吸收。无论位置如何，牙根吸收不会自行消退，如果不治疗，会持续引起不适，有时甚至导致牙齿脱落。与其他类型的牙根内吸收相比，内吸收性替代更为罕见。鉴于内吸收性替代病例稀少，本文报告了一例使用NeoPutty三氧化矿物凝聚体和锥形束计算机断层扫描进行牙根内吸收性替代牙髓治疗的病例，以说明和阐明其特征、诊断、可能病因及治疗方式。
一名55岁的伊朗男性因窦道转诊。根尖片显示根尖周病变，锥形束计算机断层扫描显示8号和9号牙存在牙根内吸收性替代。在放大条件下使用超声尖探查根管。使用2.5%次氯酸钠进行超声冲洗。将氢氧化钙作为根管内药物置于根管内2周。下次复诊时，去除氢氧化钙后，干燥根管并使用NeoPutty三氧化矿物凝聚体进行充填。在2年的随访中，牙齿叩诊无反应。
外伤可能导致牙根内吸收性替代，其具有进行性，需要立即进行牙髓治疗。三氧化矿物凝聚体似乎是治疗牙根内吸收性替代的一种有前景的材料。此外，锥形束计算机断层扫描和牙科手术显微镜可以改善某些具有挑战性病例的牙髓治疗效果。
