上颌中切牙被认为是解剖变异最小的牙齿。在文学中,据报道,上颌中切牙单根和单管的患病率为100%。只有少数病例报告表明有一个以上的根或一个根管可用,并且大多与发育异常有关,例如成牙和融合。本文介绍了一种罕见的病例报告,该病例报告通过锥形束计算机断层扫描(CBCT)证实了上颌中切牙的两个根部具有正常的临床冠。一名50岁的印度男性患者在根管治疗的前牙上出现疼痛和不适。左上颌中切牙牙髓敏感性试验阴性。口内根尖周数字X射线照片显示,有一个阻塞的管道,怀疑有第二根的轮廓,并通过锥形移位技术得到了证实。在牙科手术显微镜下对牙齿进行治疗,在此期间定位了两个运河并完成了再治疗。封堵后,进行CBCT以研究根和管的形态。临床和影像学检查,所有随访检查均显示无症状牙齿,无任何活动性根尖周病变。本病例报告强调,临床医生应以开放的心态对待每个病例,并全面了解正常牙齿的解剖结构,并应怀疑每个病例的变化,以确保成功的牙髓治疗结果。
Maxillary central incisor is considered the tooth with least anatomical variations. In literature, the prevalence of single root and single canal in maxillary central incisor has been reported as 100%. Only a handful of
case reports suggesting more than one root or one canal are available and are mostly associated with developmental anomalies such as gemination and fusion. This article describes a rare
case report of retreatment of a maxillary central incisor with two roots with normal clinical crown which was confirmed by cone-beam computer tomography (CBCT). A 50-year-old Indian male patient presented with pain and discomfort on a root canal-treated anterior tooth. Pulp sensibility testing of left maxillary central incisor was negative. Intraoral periapical digital radiograph revealed an obturated canal with suspected outline of a second root which got confirmed with cone shift technique. The tooth was treated under dental operating microscope during which two canals were located and retreatment was completed. Postobturation, CBCT was performed to study the root and canal morphology. Clinically and radiographically, all the follow-up examinations revealed an asymptomatic tooth without any active periapical lesion. The present
case report emphasizes the fact that clinicians should approach each
case with an open mind having a thorough knowledge of the normal tooth anatomy and should suspect variations in every
case to ensure successful endodontic outcome.