牙根內吸收－病例報告

Internal Root Resorption - Report of Three Cases

黃自釗(Tzyh-Jau Huang) ； 阮榮泰(Rong-Tai Roan) ； 羅文智(Wen-Jyh Rou) ； 刁名豪(Mirng-Haur Diau) ； 陳正慧(Geng-Huey Chen)

《The Kaohsiung Journal of Medical Sciences》 1卷8期 (1985/08) Pp. 521-527

https://doi.org/10.6452/KJMS.198508.0521

摘要

牙根吸收一般分為牙根內吸收及牙根汁吸收，可由根尖X光片區別診斷之。牙根內吸收是牙髓本身發生病變，而造成根管壁齒質的吸收，其真正的病因目前仍未定論，但多數學者認為主要病因可能與汁傷有關。本文報告3個病例，三者均屬牙根內吸收：第一個病例發生在病人下顎右側犬齒根尖三分之一處，臨床上可發現該顆牙齒根尖處有摟管，且該牙為牙冠牙橋之橋基牙；第二個病例發生在病人上顎右側側門齒牙根中央處，臨床上可發現牙冠近心面有一明顯的齲窩；第三個病例發生在病人上領左側第二前白齒近牙冠之牙根處，髓腔開擴復發現根管壁穿孔與牙周組織相通，有外傷之病史。因牙根內吸收之病人臨床上大多無症狀，經常是在常規X光檢查時意外發現，所以此類牙齒不易獲得適切的照顧，治療時祇要接受齒內治療處理，就可防止根管壁吸收的進行。

並列摘要

Internal root resorption is a patologic process initiated within the pulp cavity and resulting in a loss of substance of dentinal walls. The exact cause of internal resorption is still speculative, but it seems to e closely associated with trauma and chronic pulpitis.
This paper reports three cases of internal resorptive lesion: in apical third of the root of 3┐(case 1), in midroot of 2 ┘(case 2) and in cervical third of the root of └5 (case 3). In the first case there is a fistula over the apical region of 3┐ was diagnosed. A non-surgical endodontic treatment was performed, and the root canal was filled with gutta percha points and canal sealer with the lateral condensation technique. the 2 ┘in the second case has carious defect on the mesiomarginal surface. Although the vitality test of 2 ┘was positive, a non-surgical endodontic therapy was performed so that the process of internal resorption can be stopped. The root canal of 2 ┘was filled with gutta percha points and canal sealer with softened gutta percha technique. The └5 in the third case is asymptomatic and had a history of traumatic accident. During the non-surgical endodontic therapy of └5, a perforation at the cervical third of the root associated with internal resorptive process was noticed. The perforative area was packed with ZOE paste, and the root canal was filled with gutta percha points and canal sealer with lateral condensation technique.
Teeth afected by internal resorption are usually asymptomatic and are always left untreated. Most cases of internal resorption were first recognized clinicanlly during the fullmouth radiograph. As soon as internal resorption is detected in a tooth, endodontic therapy whould be performed to prevent further resorption from occurring. Otherwise, perforation of the crown by resorption provides a portal of entry for microorganisms, and this leads to pulpal infection. Resorption of the root may in time lead to root fracture.

並列關鍵字

root resorption ； trauma ； root perforation