Surgical management of a failed internal root resorption treatment: a histological and clinical report.
Surgical management of a failed internal root resorption treatment: a histological and clinical report.
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DOI：
10.5395/rde.2014.39.2.137
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Nosrat A
中科院分区：
文献类型：
--
作者：
Asgary S;Eghbal MJ;Mehrdad L;Kheirieh S;Nosrat A
本文介绍了对具有冲击创伤和穿孔内根吸收病史的三氧化二矿物质聚集体 (MTA) 正向闭塞失败的牙齿进行的成功手术治疗。转诊了一颗有症状的上颌侧切牙，该牙因内根吸收而有穿孔史，并使用 MTA 进行非手术修复。在初次就诊前 4 年，MTA 无意中过度填充了缺损。此后，多余的 MTA 已消失，并且穿孔部位附近的射线可透过的病变在射线照相中是明显的。使用富钙混合物（CEM）水泥作为修复材料进行外科牙髓再治疗。病变组织学检查显示有慢性炎症的肉芽组织，以及纤维结缔组织内包裹的 MTA 小片段。在一年和两年的随访检查中，所有疾病的体征和症状都已消失，牙齿功能正常。初次就诊两年后，观察到病变的放射线完全愈合。本病例报告说明了选择适当的穿孔治疗方法如何影响牙齿的长期预后。此外，应避免将 MTA 挤出到根周病变中。
This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.