显微根尖手术联合活髓保存术治疗阻生牙所致的下颌第二磨牙牙根外吸收  

Combined micro-apical surgery and vital pulp therapy in mandibular second molars with external root resorption caused by impacted teeth

作　　者：宋东哲[1] 罗雨 刘显[2] 胡沛 黄定明[1] Song Dongzhe;Luo Yu;Liu Xian;Hu Pei;Huang Dingming(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Cariology and Endodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Oral and Maxillofacial Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China;State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of General Dentistry,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室、国家口腔疾病临床医学研究中心、四川大学华西口腔医院牙体牙髓病科,成都610041 [2]口腔疾病研究国家重点实验室、国家口腔疾病临床医学研究中心、四川大学华西口腔医院口腔颌面外科,成都610041 [3]口腔疾病研究国家重点实验室、国家口腔疾病临床医学研究中心、四川大学华西口腔医院口腔全科,成都610041

出　　处：《华西口腔医学杂志》2023年第2期225-231,共7页West China Journal of Stomatology

基　　金：四川省重点研发项目(2021YFS0031);四川大学华西口腔医院探索与研发项目(LCYJ2019-6)。

摘　　要：目的对阻生牙所致的下颌第二磨牙牙根外吸收的病例,提出一种新的治疗方式以保存患牙及其活髓。方法对临床诊断为阻生牙所致牙根外吸收的下颌第二磨牙,联合口腔颌面外科与牙体牙髓病科,在阻生牙拔除即刻,对第二磨牙外吸收的牙根通过显微根尖手术于外吸收部位清创并切除根尖,通过活髓保存术于截根面以生物活性材料直接盖髓。结果患牙牙根外吸收停止,术后1年随访患牙无症状,牙冠完整,牙髓组织正常,影像学检查根尖周未见透射影,牙周膜间隙正常,骨硬板连续,牙槽骨重建,预后良好。结论在阻生牙拔除同期联合显微根尖手术及活髓保存术,可保存阻生牙所致牙根外吸收的下颌第二磨牙牙髓活力,有望成为该疾病的候选治疗方案之一。Objective This study aimed to establish a new treatment of the mandibular second molars with external root resorption caused by impacted teeth to preserve the affected teeth and their vital pulps.Methods For mandibular second molars clinically diagnosed as external root resorption caused by impacted teeth,debridement and removal of the root at the resorption site via micro-apical surgery and direct capping of the pulp with bioactive material on the surface of the root amputation via vital pulp therapy were performed immediately after the impacted teeth were extracted.Results The external root resorption of the affected tooth was ceased.It was asymptomatic with intact crown,normal pulp,periapical alveolar bone reconstruction,normal periodontal ligament,continuous bone sclerosis,and no periapical translucency in radiographic examination at the 1-year postoperative follow-up,thus showing good prognosis.Conclusion Simultaneous combination of micro-apical surgery and vital pulp therapy after extraction of impacted teeth could successfully preserve mandibular second molars with ERR caused by impacted teeth and their vital pulps.

关 键 词：显微根尖手术 活髓保存术 牙根外吸收 阻生牙 下颌第二磨牙 

分 类 号：R781.05[医药卫生—口腔医学]