Endodontic management of a fused left maxillary second molar and two paramolars using cone beam computed tomography: A case report  

作　　者：Xiao-Han Mei Jin Liu Wei Wang Qian-Xia Zhang Tao Hong Shi-Zhu Bai Xiao-Gang Cheng Yu Tian Wen-Kai Jiang 

机构地区：[1]Department of Operative Dentistry and Endodontics,School of Stomatology,The Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China [2]Department of Stomatology,Huangshan City People's Hospital,Huangshan 245000,Anhui Province,China [3]Digital Dentistry Center,School of Stomatology,The Fourth Military Medical University,Xi'an 710032,Shaanxi Province,China

出　　处：《World Journal of Clinical Cases》2022年第23期8367-8374,共8页世界临床病例杂志

基　　金：Supported by the Innovative Talents Promotion Program-Youth Science and Technology Star Project,No. 2019KJXX-086;Shaanxi Provincial Natural Science Basic Research Foundation of China,No. 2019JM-376;National Nature Science Foundation of China,No. 81970929

摘　　要：BACKGROUND Fused teeth usually involve several complications,such as the development of caries in the groove between fused crowns,tooth impaction,diastemas,aesthetic and periodontal problems,and pulpal pathosis,due to the complex anatomical structure of fused teeth.A thorough diagnosis is paramount to forming an accurate treatment plan and obtaining a favourable prognosis.With the advent of cone-beam computed tomography(CBCT),accurate 3-dimensional images of teeth and their surrounding dentoalveolar structures can now be readily obtained,and the technology can accurately provide a minimally invasive approach to acquire detailed diagnostic information.Therefore,we utilize CBCT data herein to generate a digital model for the infected region in a patient,and this model enables us to better plan the management of his case.CASE SUMMARY This report details the diagnosis and endodontic treatment of a rare case involving a fused maxillary second molar and two paramolars with apical periodontitis.The patient experienced pain upon biting and cold sensitivity in the area of the maxillary left molar.No caries or other defects were identified in these teeth,and a normal response to a pulp electric viability test was observed.With the aid of CBCT and digital model technology,we initially suspected that the infection originated from the isthmus between the maxillary second molar and two paramolars.Therefore,we only treated the isthmus by an endodontic approach and did not destroy the original tooth structure;furthermore,the vital pulp was retained,and good treatment outcomes were observed at the 24-month follow-up.CONCLUSION This finding may provide new insights and perspectives on the diagnosis and treatment of fused teeth.

关 键 词：Cone-beam computed tomography scans Endodontic therapy Fusion of teeth Maxillary molar Digital model technology Case report 

分 类 号：R781.42[医药卫生—口腔医学]