- 期刊
以引導組織再生術治療伴隨有牙根表面牙結石狀沉著物的齒根尖周圍病灶－病例報告
Treatment of a Periapical Lesion Associated with Calculus-like Deposits on Root Surface by Guided Tissue Regeneration Technique-A Case Report
摘要
一般伴隨廔管之齒根尖周圍病灶，經傳統齒內治療後，多能自行修復。本報告患者是一位二十九歲的女性，左下顎第一大臼齒有一伴隨一年多廔管之齒根尖周圍病灶，X光檢查發現其大小約8mm×10mm，經過傳統齒內治療，觀察二個月後，廔管依然存在，於是決定做根尖手術且把齒根尖切除。手術時將病灶摘出後送活體檢查，此時發現牙根表面上有牙結狀沉著物，經徹底刮除後，因齒槽骨缺損過大，因此同時施行引導組織再生術治療，植入脫鈣冷凍乾燥骨粉（demineralized freeze-dried bone allograft, DFDBA）並以鈦金屬加強型不可吸引再生膜覆蓋。活體檢查報告為一根尖囊腫。一個月後因再生膜暴露而將之移除，術後十六個月回診，廔管已消失並無伴隨其它臨床症狀。X光檢查發現齒根尖周圍病灶範圍 縮小至5mm×6mm。本報告同時探討牙根表面之牙結石狀沉著物來源及其是否與齒根尖周圍囊腫有關與大型齒根尖周圍病灶治療方式。
並列摘要
The periapical lesion associated with fistula could usually repair after receiving a proper conventional endodontic treatment. A 29 year-old female patient with a periapical lesion and fistula on her left mandibular first molar for more than one year. The size of the lesion was about 8 mm×10 mm on the periapical film. The tooth was soon treated with the conventional endodontic therapy. Two months later, the fistula was still present. Therefore a periapical surgery was planned and carried out. In the surgery, there were some calculus-like deposits on the distal root surface. After thorough root planing and root end resection of the distal root, a huge bony defect was found and we decided to combine with membrane technique. The demineralized freeze-dried bone allograft (DFDBA) was placed in the bony defect and was covered with a titanium-reinforced e-PTFE nonresorbable barrier membrane. One month later, the membrane was removed because of early membrane exposure. The pathologic report confirmed an apical cyst. Seven months later, the fistula disappeared, no further symptom and sign were noted. The size of the lesion was 5 mm×6 mm on the periapical film. Some related questions regarding to calculus-like deposits are also discussed.