Regenerative treatment of an immature, traumatized tooth with apical periodontitis: Report of a case
Regenerative treatment of an immature, traumatized tooth with apical periodontitis: Report of a case
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DOI：
10.1016/j.joen.2008.02.029
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发表时间：
2008-05-01
影响因子：
4.2
通讯作者：
Lusso, Daniela
中科院分区：
文献类型：
--
作者：
Cotti, Elisabetta;Mereu, Manuela;Lusso, Daniela
本病例报告描述了一个坏死的未成熟的永久中切牙的治疗与完全冠骨折，怀疑根骨折，窦道，这是没有用传统的根尖诱导技术。相反，提供了一种基于创伤文献血运重建方法的再生方法。用尖匙挖掘器轻轻清除根管中的坏死组织，用NaOCl冲洗根管长度的三分之一，然后用氢氧化钙进行药物治疗。15天后，窦道愈合，牙齿无症状。进入牙齿，去除氢氧化钙，刺激出血以形成根管内血凝块，并将三氧化矿物聚集体置于血凝块的冠状面。8个月后，冠状面钙化屏障在X线片上明显，并伴有根壁和根尖闭合的进行性增厚。治疗开始后两年半，牙齿仍然无症状，窦道未再次出现。牙本质壁厚度的逐渐增加和随后的根尖发育表明，对具有窦道的坏死的未成熟恒牙进行这种类型的治疗可以产生适当的生物反应。
This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure, Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth with sinus tract.