PDF(Pubmed)
Abstract：
BACKGROUND: Endodontic surgery, which includes apex resection, retro-fill and some regeneration procedures, is a traditional way to deal with apex fenestration. The endodontic surgery could bring large flap, curtate root length, non-healing mucosa and soft tissue deficiency in the apex area. Other treatment options might be considered according to different etiological factors. Mucogingival surgery provides some ideas in accumulation of soft and hard tissues, especially some unique methods such as \"tunnel technique\" bringing us a view of minimal invasive surgery approach. A novel surgery named \"apical tunnel surgery\" was reported here to resolve a root apex exposure with the tunnel-like technique.
METHODS: A young female complained about root exposure of upper right anterior tooth without history of trauma or orthodontic treatment.
METHODS: The intraoral examination revealed a buccal root apex exposure about 3mm in diameter of #12 (FDI teeth numbering system). The tooth was slightly dark with Class 1 mobility. The periodontal situation was good and the occlusion check revealed no traumatic bite on #12. The cone-beam computed tomography (CBCT) showed a bone fenestration from the buccally lower 1/2 root surface to the apex and bone absorption around the apex. It also revealed a bone contour deficiency in #12 area.
METHODS: Root canal treatment, root surface debridement, and soft tissue combined with hard tissue accumulation were carried out in one tunnel-like surgery.
RESULTS: Examination of 12-month follow-up showed a healed and thickened mucosa in the buccally apical region and CBCT showed the continuous lamina dura occupied the buccal aspect of #12 root apex.
CONCLUSIONS: This new apical tunnel surgery provided soft and hard tissue accumulation in one minimal invasive way in the apex exposure case caused by bone fenestration and thin mucosa.
METHODS: A young female complained about root exposure of upper right anterior tooth without history of trauma or orthodontic treatment.
METHODS: The intraoral examination revealed a buccal root apex exposure about 3mm in diameter of #12 (FDI teeth numbering system). The tooth was slightly dark with Class 1 mobility. The periodontal situation was good and the occlusion check revealed no traumatic bite on #12. The cone-beam computed tomography (CBCT) showed a bone fenestration from the buccally lower 1/2 root surface to the apex and bone absorption around the apex. It also revealed a bone contour deficiency in #12 area.
METHODS: Root canal treatment, root surface debridement, and soft tissue combined with hard tissue accumulation were carried out in one tunnel-like surgery.
RESULTS: Examination of 12-month follow-up showed a healed and thickened mucosa in the buccally apical region and CBCT showed the continuous lamina dura occupied the buccal aspect of #12 root apex.
CONCLUSIONS: This new apical tunnel surgery provided soft and hard tissue accumulation in one minimal invasive way in the apex exposure case caused by bone fenestration and thin mucosa.
摘要：
背景：牙髓手术，其中包括根尖切除术，回填和一些再生程序，是处理顶点开窗的传统方法。牙髓手术可能会带来大皮瓣，曲线根长，先端区粘膜不愈合，软组织缺损。根据不同的病因，可能会考虑其他治疗方案。粘膜牙龈手术为软组织和硬组织的积累提供了一些想法，特别是一些独特的方法，如“隧道技术”给我们带来了一种微创手术方法的观点。这里报道了一种名为“根尖隧道手术”的新颖手术，该手术使用类似隧道的技术解决了根尖暴露。
方法：一名年轻女性主诉右上前牙牙根暴露，无外伤或正畸治疗史。
方法：口内检查显示＃12（FDI牙齿编号系统）直径约3mm的颊根尖暴露。牙齿略暗，具有1级活动性。牙周情况良好，咬合检查显示＃12无创伤性咬伤。锥形束计算机断层扫描（CBCT）显示从颊下部1/2根表面到心尖的骨开窗和心尖周围的骨吸收。它还揭示了＃12区域的骨轮廓缺陷。
方法：根管治疗，根面清创，在一次隧道样手术中进行软组织和硬组织积聚。
结果：12个月随访检查显示颊尖区粘膜愈合增厚，CBCT显示连续硬膜占据了12号根尖的颊侧。
结论：这种新的根尖隧道手术在骨开窗和薄粘膜引起的根尖暴露病例中以一种最小的侵入性方式提供了软组织和硬组织的积聚。
方法：一名年轻女性主诉右上前牙牙根暴露，无外伤或正畸治疗史。
方法：口内检查显示＃12（FDI牙齿编号系统）直径约3mm的颊根尖暴露。牙齿略暗，具有1级活动性。牙周情况良好，咬合检查显示＃12无创伤性咬伤。锥形束计算机断层扫描（CBCT）显示从颊下部1/2根表面到心尖的骨开窗和心尖周围的骨吸收。它还揭示了＃12区域的骨轮廓缺陷。
方法：根管治疗，根面清创，在一次隧道样手术中进行软组织和硬组织积聚。
结果：12个月随访检查显示颊尖区粘膜愈合增厚，CBCT显示连续硬膜占据了12号根尖的颊侧。
结论：这种新的根尖隧道手术在骨开窗和薄粘膜引起的根尖暴露病例中以一种最小的侵入性方式提供了软组织和硬组织的积聚。
