Hokett S D, Hoen M M
J Periodontol. 1998 Feb;69(2):219-26. doi: 10.1902/jop.1998.69.2.219.
An unusual case of bilateral inflammatory external/internal root resorption developed in the maxillae of a 28 year-old female approximately 4 years following routine segmental orthognathic surgery. The patient experienced dental pain in a tooth adjacent to a segmental osteotomy cut 8 months postsurgery, however, the tooth later became asymptomatic. A definitive diagnosis of inflammatory cervical root resorption was not established until nearly 4 years later on routine dental examination. The external/internal resorptive lesions were located 4 to 6 mm apical to the connective tissue attachment on 3 of the 4 tooth roots adjacent to osteotomy cuts. Two of the affected teeth required non-surgical root canal therapy due to pulpal communication with the resorptive defects. The lesions were accessed by flap surgery, thoroughly debrided, and obturated with an intermediate restorative material until definitive restorative therapy could be completed. All sites healed uneventfully and the patient has been closely observed for approximately 2 years without symptoms or recurrence of the resorptive lesions. Dental health care providers should be alert to the possible occurrence of inflammatory root resorption in sites adjacent to osteotomy cuts over extended periods of time. Routine radiographic examination may be beneficial in the postoperative management of the segmental orthognathic surgery patient.
一名28岁女性在进行常规节段性正颌手术后约4年,上颌出现双侧炎性牙根内外吸收的罕见病例。患者在术后8个月时,靠近节段性截骨切口的一颗牙齿出现牙痛,但该牙齿后来无症状。直到近4年后进行常规牙科检查时,才确诊为炎性颈段牙根吸收。在靠近截骨切口的4颗牙根中的3颗,其内外吸收性病变位于结缔组织附着根尖4至6毫米处。由于牙髓与吸收性缺损相通,其中2颗患牙需要进行非手术根管治疗。通过翻瓣手术暴露病变部位,彻底清创,并用中间修复材料充填,直至完成确定性修复治疗。所有部位均顺利愈合,对患者进行了约2年的密切观察,未出现症状或吸收性病变复发。牙科保健人员应警惕在截骨切口附近长时间发生炎性牙根吸收的可能性。常规影像学检查可能有助于节段性正颌手术患者的术后管理。