目的:本报告针对一名11岁男孩的大面积持续性放电损伤的处理。该报告描述了使用抽吸冲洗技术来管理再生程序失败后持续放电的未成熟坏死牙齿。
背景:再生牙髓药旨在增加根管宽度,长度,并在顶端闭合。替代程序,如apexification,当再生失败时应该尝试。如果运河不能干燥到持续排放,可以使用抽吸灌溉技术。该技术依赖于使用抽吸和冲洗来从根尖周区域去除脓液。
方法:这是一个11岁患者的病例,该患者的11号牙齿外伤导致复杂的牙冠骨折。他接受了紧急管理,包括在另一家诊所进行牙髓切除术和肛门内药物治疗。两年后,病人被送到我们的诊所。经检查,该诊断以前是在未成熟的11号牙齿中进行无症状根尖周炎的治疗。首先尝试再生,但失败了。取下矿物三氧化物集料(MTA)塞,运河有持续的脓液排出。运河里充满了肛门内药物,两周后,运河充满了三重抗生素糊剂(TAP)。下一次访问,由于持续放电,11号牙齿采用肛门内抽吸冲洗技术进行保守治疗。使用连接到高容量抽吸的IrriFlex针来抽吸囊液。在随后的访问中进行了三氧化物矿物聚集体塞的剥脱术,并修复了牙齿。
结论:在3个月和16个月的随访期间,症状有所缓解,根尖周病变大小的减小,软组织出现在正常范围内。
结论:再生手术对于未成熟的坏死牙齿是一个很好的选择。由于根管持续的脓液排出,这些程序可能会失败。在有意识地排出运河的情况下,抽吸灌溉技术是一种很好的治疗选择。如何引用这篇文章:AlsofiL,AlmarzoukiS.通过改良的抽吸灌溉技术和松解术治疗再生牙髓失败的病例。JConempDentPract2024;25(1):92-97。
OBJECTIVE: This report addresses the management of a large persistent discharging lesion in an 11-year-old boy. The report describes the use of aspiration-irrigation technique for the management of immature necrotic tooth with persistent discharge after a failed regenerative procedure.
BACKGROUND: Regenerative endodontics aim to provide an increase in root canal width, length, and in apical closure. Alternative procedures, such as apexification, should be attempted when regeneration fails. If the canal cannot be dried to persistent discharge, the aspiration-irrigation technique can be used. The technique relies on using aspiration along with irrigation to remove pus from the periapical area.
METHODS: This is a
case for an 11-year-old patient who had trauma to tooth #11, which resulted in the complicated crown fracture. He had an emergency management that included pulpectomy and intracanal medication at another clinic. Two years later, the patient was presented to our clinic. Upon examination, the diagnosis was previously initiated therapy with asymptomatic apical periodontitis in immature tooth #11. Regeneration was attempted first but failed. The mineral trioxide aggregate (MTA) plug was removed, and the canal had persistent pus discharge. The canal was filled with intracanal medication, and then 2 weeks later, the canal was filled with triple antibiotic paste (TAP). Next visit, and due to continuous discharge, tooth #11 was treated conservatively with an intracanal aspiration-irrigation technique. An IrriFlex needle attached to a high-volume suction was used to aspirate the cystic fluid. Mineral trioxide aggregate plug apexification was performed in a later visit and the tooth was restored.
CONCLUSIONS: During the 3-month and 16-month follow-up, there was resolution of the symptoms, a decrease in the periapical lesion size, and soft tissues appeared within normal limits.
CONCLUSIONS: Regenerative procedures are a good option for immature necrotic teeth. These procedures may fail due to persistent pus discharge from the root canals. The aspiration-irrigation technique is a good treatment option in cases of consciously discharging canals. How to cite this article: Alsofi L, Almarzouki S. Failed Regenerative Endodontic
Case Treated by Modified Aspiration-irrigation Technique and Apexification. J Contemp Dent Pract 2024;25(1):92-97.