PDF(Pubmed)
Abstract：
Extrusion of root filling material had been shown to reduce the success of endodontic treatment. This case report describes the management of a patient who reported prolonged, persistent, and increasing pain on an upper root filled central incisor with extruded root filling material. A 28-year-old female patient came with the chief complaint of pain and tenderness on the upper left central incisor. The pain was mostly triggered by mastication. Upon examination and investigation, the tooth of concern was tooth 21 which was a root treated many years ago. It appeared to have tenderness on percussion and palpation. Non-surgical root canal retreatment was completed on tooth 21. However, the patient complained of the same pain while biting even after six months post-obturation. Therefore, endodontic microsurgery was performed to remove the root filling material that was extruded and to enucleate the granulomatous lesion around the periapical region of tooth 21. After enucleation, apical root end resection was performed. Postoperatively, the patient reported comfort and no pain and was able to resume her daily activities. At six months of review, the radiograph showed evidence of complete healing. This case report captured the importance of endodontic microsurgery as a viable treatment option where nonsurgical root canal retreatment failed to relieve the patient\'s symptoms.
摘要：
根填充材料的挤压已被证明会降低牙髓治疗的成功率。此病例报告描述了一名报告时间过长的患者的管理，持久性,用挤压的根填充材料增加上根填充的中切牙的疼痛。一名28岁的女性患者主诉左上中切牙疼痛和压痛。疼痛主要是由咀嚼引起的。经审查和调查，关注的牙齿是21号牙齿，这是多年前治疗的牙根。在敲击和触诊时似乎有压痛。在21号牙齿上完成了非手术根管再治疗。然而,即使在封堵后6个月，患者仍在咬人时抱怨同样的疼痛。因此,进行了牙髓显微手术,以去除被挤出的牙根填充材料,并摘除牙齿21根尖周围的肉芽肿性病变.摘除后,根尖端切除。术后,患者报告舒适且无疼痛,能够恢复日常活动.在六个月的审查中，X光片显示完全愈合的证据.该病例报告强调了牙髓显微手术作为一种可行的治疗选择的重要性，其中非手术根管再治疗未能缓解患者的症状。
