A 63-year-old patient presented with a periapical radiolucency on tooth #10. After evaluation, the patient was diagnosed with an endodontic-periodontal lesion associated with PRG. After being informed of a guarded prognosis, the patient consented to a surgical procedure in an effort to retain the tooth. Management of the case involved a combination of endodontic therapy, odontoplasty under dental operating microscopy to attempt to eliminate the root anomaly, and periodontal regenerative procedures with allografts and a resorbable barrier membrane. Clinical examination and the cone-beam computed tomography scan at a 2-year postoperative visit revealed a substantial reduction in probing depth and significant bone fill of the defect.
In the past, a long PRG in combination with a periapical lesion often resulted in extraction of the tooth. With accurate assessment of the etiology of the defect, patient education, and a multidisciplinary approach, teeth with a PRG may be retained with a stable outcome for years.
一名63岁的患者在10号牙齿上表现为根尖周射线不透性。经过评估,患者被诊断患有与PRG相关的牙髓-牙周病.在被告知保守的预后后,患者同意进行外科手术以保留牙齿。该病例的管理涉及牙髓治疗的组合,在牙科手术显微镜下进行牙列成形术,以试图消除牙根异常,和具有同种异体移植物和可吸收屏障膜的牙周再生程序。术后2年的临床检查和锥形束计算机断层扫描显示,探查深度和缺损的骨填充显着减少。
在过去,长PRG与根尖周病变相结合通常会导致拔牙。随着对缺陷病因的准确评估,患者教育,和多学科方法,带有PRG的牙齿可以保留多年,结果稳定。