Manaswini Pucha Sai, Prabhuji Varun, Champa C, Veeralakshmi P, Pai S Veena
Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India.
Roots to Cusps® Private Limited, Bengaluru, Karnataka, India.
J Conserv Dent Endod. 2025 Jul;28(7):704-707. doi: 10.4103/JCDE.JCDE_244_25. Epub 2025 Jul 2.
Discoloration of nonvital anterior teeth, often resulting from pulpal necrosis and associated periapical pathology, poses both functional and esthetic challenges. Conservative management that addresses both biological healing and esthetics is essential in such cases. A 45-year-old female presented with pain and discoloration in the maxillary anterior region. Clinical and radiographic examination revealed a nonvital, discolored tooth 11 with a large periapical lesion and initial periapical changes in tooth 12. Root canal treatment was performed on both teeth using HyFlex EDM files and ultrasonically activated irrigation protocol. Obturation was completed using a bioceramic sealer. Intracoronal bleaching of tooth 11 was attempted using sodium perborate and hydrogen peroxide, but minimal improvement in shade necessitated direct composite veneers for teeth 11 and 12. Tooth 13 was also veneered upon the patient's request. The patient was followed up at 3, 6, 9, and 12 months, with satisfactory clinical and radiographic outcomes. A combination of conservative endodontic treatment and minimally invasive esthetic rehabilitation can effectively manage nonvital, discolored anterior teeth, ensuring both functional success and patient satisfaction.
无活力前牙的变色，通常由牙髓坏死及相关根尖周病变引起，会带来功能和美观两方面的挑战。在这类病例中，兼顾生物愈合和美观的保守治疗至关重要。一名45岁女性上颌前部出现疼痛和变色。临床及影像学检查发现11号牙无活力、变色，伴有较大根尖周病变，12号牙有初期根尖周改变。对两颗牙齿均使用HyFlex EDM锉和超声激活冲洗方案进行根管治疗。使用生物陶瓷封闭剂完成根管充填。尝试用硼酸钠和过氧化氢对11号牙进行冠内漂白，但色泽改善甚微，因此需要对11号牙和12号牙进行直接复合树脂贴面修复。应患者要求，13号牙也进行了贴面修复。在3、6、9和12个月时对患者进行随访，临床和影像学结果均令人满意。保守性牙髓治疗与微创美学修复相结合能够有效处理无活力、变色的前牙，确保功能成功并使患者满意。
