- 期刊
Diagnosis and Management of External Cervical Resorption in Immature Permanent Teeth: A Case Report
年輕恆牙之齒頸部外吸收的診斷與處置：病例報告
摘要
External cervical resorption (ECR) is a type of pathological root resorption that leads to progressive destruction of dental hard tissues. While often being asymptomatic, ECR can significantly compromise the tooth structure and eventually cause tooth loss if early detection and proper treatment are not carried out. However, the unknown etiology and frequently unnoticeable clinical presentations of ECR pose significant challenges in its prevention, diagnosis, and management. While certain treatment modalities and protocols for ECR have been proposed by previous individual reports and case series, they are primarily, if not exclusively, for permanent teeth with complete root formation. This report describes a rare case of ECR in an immature maxillary central incisor. To preserve more tooth structure and pulp vitality for continued root development, a multi-step conservative approach of vital pulp therapy using calcium hydroxide and Biodentine^(TM) (Septodont, Saint-Maur-des-Fossés, France) was implemented. One and half years after treatment, the lesion showed no signs of progression or recurrence, and the tooth has remained vital and exhibited uneventful root formation. Our report not only demonstrates a rare case of ECR but also establishes a feasible treatment protocol for young permanent teeth affected by ECR.
並列摘要
齒頸部外吸收（External cervical resorption, ECR）是一種罕見之病理性牙根吸收。雖然臨床上通常沒有明顯之症狀，但未治療之病變可能導致嚴重而無法修復的齒質喪失。由於病因仍不明確以及難以診斷的特性，至今尚無預防或治療此疾病的準則。因為疾病之罕見性，目前對於齒頸部外吸收的治療概念與方法主要來自一些病例報告。然而此類報告與研究主要針對成熟且牙根發育完全之恆牙。本病例報告描述一例發生於年輕上顎正中恆門齒的齒頸部外吸收，並針對其可能成因、診斷方法與處置進行討論。對於此類牙根發育尚未完全之年輕恆牙，由於須注意保留齒髓活性，並同時保存更多牙齒結構，因此治療更具挑戰性。我們採用多步驟之保守性治療，僅針對吸收病變進行部分移除，並使用氫氧化鈣和Biodentine^(TM)（Septodont, Saint-Maur-des-Fossés, France）進行活髓處置。該牙齒於治療後一年半的追蹤期間內無明顯之臨床症狀，且仍保持牙髓活性，並維持正常的根尖發育和牙齒萌發。文獻回顧顯示本篇案例報告為首例發生於年輕恆牙之齒頸部外吸收。所建立起的治療方式可為臨床上此類罕見病變提供一個可行且有效的處置方式。