牙外伤会导致各种并发症,并给从业者带来谜团。钙化性变态是创伤的后遗症之一。一名35岁的女性患者前往牙髓病专科诊所治疗变色的牙齿。临床上,观察到21变色,触诊和敲击无疼痛。纸浆敏感性测试显示为阴性反应。X线照相检查显示牙髓管闭塞,心尖射线不透性为心尖指数(PAI4)。牙齿被诊断为无症状根尖周炎的坏死牙髓。尝试在牙科手术显微镜下协商运河(LABOMED,洛杉矶,CA,美国)和超声波(卫星,Acteon,法国)是徒劳的。锥形束计算机断层扫描图像显示根尖三分之一的通气管。使用具有动态导航系统的实时引导牙髓药(Navident,ClaroNav,多伦多,ON,加拿大),计划的协议,trace,地方被跟踪,运河谈判取得了成功。射线照相确认后,根管治疗完成。
Dental trauma results in various complications and poses an enigma to the practitioner. Calcific metamorphosis is one of the sequelae of trauma. A female patient of 35 years visited the specialty clinic of endodontics for the management of a discolored tooth. Clinically, discolored 21 was observed with no pain on palpation and percussion. The pulp sensibility test revealed a negative response. Radiographic examination revealed pulp canal obliteration with an apical radiolucency of Peri Apical Index (PAI 4). The tooth was diagnosed as necrotic pulp with asymptomatic apical periodontitis. Attempt to negotiate the canal under a Dental Operating Microscope (LABOMED, Los Angeles, CA, USA) and ultrasonics (Satelec, Acteon, France) was futile. Cone-beam computed tomography image revealed a patent canal in the apical third. Using real-time guided endodontics with a dynamic navigation system (Navident, ClaroNav, Toronto, ON, Canada), the protocol of plan, trace, and place was followed, and successful canal negotiation was achieved. After radiographic confirmation, root canal treatment was completed.