上顎左側第一小臼齒因牙周炎引起牙髓壞死合併根管與牙周治療：病例報告

患者為68歲女性，於2011年8月23日由診所轉至本院牙周病科就診，主訴為左上後牙處牙肉腫脹流血。臨床檢查發現上顎左側第一小臼齒遠心頰側牙周囊袋探測有5 mm、遠心腭側有7 mm並合併有探測流血，牙齦上齒質健康，沒有齲齒填補、牙齦萎縮以及咬合干擾，根尖周圍觸診無疼痛情形。牙髓活性測試仍有反應且在常值範圍內，初始臆斷為慢性牙周炎。2012年1月31日回診時，發現頰側有瘻管出現，X光片根尖處有陰影病灶，呈現牙髓壞死。於原診所根管治療後，在本院接受手術性根管治療及牙周再生手術治療。牙周病灶與牙髓病灶會藉由牙周組織與牙髓組織互相影響，治療方法與預後也不同，此篇報告提出一個因牙周炎而引起牙髓壞死合併治療個案，觀察追蹤其治療結果。

關鍵字

牙周與牙髓合併病灶；逆行性牙髓炎；手術性根管治療；牙周再生手術

並列摘要

A 68-year-old female patient was referred to our periodontal clinic on 8/23/2011 with her chief complaint being gum swelling and bleeding over maxillary left posterior area. The clinical examination showed a probing depths of 5mm on the disto-buccal side and of 7 mm on the disto-palatal side with bleeding upon probing. No tooth decay, filling material, gingival recession, occlusal interferences or palpation pain was noted. The electric pulp test showed positive results and was within normal limits. The differential diagnosis was chronic periodontitis. When the patient returned to our clinic for follow up on 1/31/2012, a fistula was found affecting the buccal vestibule. Based on the periapical radiograph, apical radiolucency was noted, and the electric pulp test showed negative results. The patient then received root canal therapy at a local dental clinic and later accepted surgical endodontic treatment and periodontal regenerative surgery at our hospital. Although the periodontal lesion and the endodontic lesion would have effects on each other via the periodontal tissue and endodontic tissue, the treatment and prognosis of these lesions is different. This paper describes a clinical case of periodontal-endodontic combined treatment for pulp necrosis of the maxillary left first premolar that was caused by chronic periodontitis.

並列關鍵字

periodontal-endodontic combined lesions ； retrograde pulpitis ； surgical endodontic treatment ； periodontal regenerative surgery

國際替代計量

上顎左側第一小臼齒因牙周炎引起牙髓壞死合併根管與牙周治療：病例報告

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