以根尖手術治療根管穿孔之下顎第一小臼齒：病例報告

Surgical Treatment of a Premolar with Perforation

楊瓊宜(Yang CY) ； 楊正媺(Yang CM) ； 李詔婷(Lee CT) ； 陳偉勵(Chen WL) ； 宋宜駒(Sung YC)

《中華民國家庭牙醫學雜誌》 17卷2期 (2022/09) Pp. 35-40

https://doi.org/10.6566/JFD.202209_17(2).0006

摘要

下顎第一小臼齒根管形態多變，易造成臨床上根管治療的困難。若無法確實掌握根管系統形態及徹底清創，容易造成根管治療失敗，甚至併發根管穿孔等意外。本病例報告為一下顎第一小臼齒因非手術性根管治療失敗，使用錐狀射束電腦斷層掃描（cone-beam computed tomography, CBCT）檢查發現根管形態複雜且合併穿孔，以根尖手術進行處置及穿孔修補。術後癒合良好，十七個月的追蹤，病患無不適且牙根尖放射照片上可見到根尖病灶已完全癒合。

關鍵字

下顎第一小臼齒 ； 牙根穿孔 ； 根尖手術 ； 錐狀射束電腦斷層掃描

並列摘要

Complex root canal system of mandibular first premolars leads to difficulties of conventional endodontic treatment. Lack of thorough knowledge of the root canal morphology and inability to treat all canals of the root canal system effectively may cause endodontic failure and iatrogenic complications. This case report presents the use of CBCT to identify complicated root canal system and perforations in a mandibular first premolar after conventional root canal treatment failure. Periapical surgery and surgical repair of the perforation were performed. Healing was uneventful, and at the 17-month recall, the patient had no symptoms and the periapical radiograph showed complete healing of the periapical lesion.

並列關鍵字

mandibular first premolar ； perforation ； apical surgery ； CBCT