上顎小臼齒水平牙根斷裂造成之牙周－牙髓合併病灶：病例報告

Horizontal Root Fracture of Maxillary Premolar with Associated periodontal-endodontic Lesion: A Case Report

王振穎(Chen-Ying Wang) ； 陳俊利(Chun-Li Chen) ； 陳忠齊(Shih-Chi Chen) ； 藍正邦(Cheng-Pang Lan) ； 蔡宜玲(Yi-Ling Tsai)

《臺灣牙周病醫學會雜誌》 15卷2期 (2010/06) Pp. 143-148

摘要

後牙的水平牙根斷裂報告相當罕見，一般水平牙根斷裂多發生在遭遇外傷後的門齒。本病例將報告一非外傷性的上顎小臼齒水平牙根斷裂及其治療與觀察。其水平牙根斷裂發生於顎側牙根中三分之一處，臨床檢查在近心顎側有過深牙周囊袋形成及牙髓壞死現象，爲一牙周－牙髓合併病炬，經過局部沖洗及加強病患牙菌斑控制，並進行根管治療，發現有些微錯位，後續完成根管內固定及齒間固定，緊接做咬合調整。術後一年放射線檢查發現齒頸部有齒槽骨板形成現象，臨床檢查探測沒有超過3mm的牙周囊袋，囊袋探測時亦沒有出血發炎的情形。此治療的方針可做爲治療因水平牙根斷裂造成之牙周－牙髓合併病灶時的參考。

關鍵字

水平牙根斷裂 ； 上顎小臼齒 ； 牙周－牙髓合併病灶 ； 根管內固定 ； 齒間固定

並列摘要

Horizontal root fractures are rare in posterior teeth. Most of horizontal root fractures occur in anterior teeth due to traumatic injury. We report one case of palatal root fracture in maxillary first premolar with successful treatment in one year recall. In this case, the radiographic examination revealed a horizontal radiolucent line on the middle third of palatal root. The tooth displayed narrow and deep pockets at mesial-palatal aspect and the electronic pulpal test showed pulpal necrosis which communicated as the periodontal-endodontic combined lesion. We irrigated the periodontal pocket and enhanced the plaque control, and then the conventional root canal therapy was done. The following intraradicular splinting and interdental splinting were performed for displacement reason. Occlusal adjustment was done as well. Radiographic examination showed lamina dura formation at root cervical third area after one year recall. Probing depth within 3 mm and no bleeding on probing were noted. The case may suggest a successful treatment modality for posterior teeth horizontal root fracture which lead into periodontal-endodontic combined lesion.

並列關鍵字

horizontal root fracture ； maxillary premolar ； periodontal-endodontic lesion ； intraradicular splinting ； interdental splinting