此病例报告描述了与上颌侧切牙上的长palato-radicious沟(PRG)相关的广泛的牙髓-牙周病合并病变的协作管理。在牙髓学杂志上报道的严重程度相似的病例很少,但在牙周杂志上报道的病例甚至更少。此病例报告说明了与PRG相关的合并病变的多学科治疗的结果。
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。
This
case report describes the collaborative management of an extensive combined endodontic-periodontal lesion related to a long palato-radicular groove (PRG) on a maxillary lateral incisor. Cases with similar severity have been reported minimally in the endodontic journals but even less in the periodontal journals. This
case report illustrates the result of multidisciplinary treatment of the combined lesions associated with PRG.
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.