植體－牙髓合併病灶：病例報告

IMPLANT-ENDODONTIC COMBINED LESION: A CASE REPORT

田俊文(Chun-Wen Tien) ； 廖連宏(Lian-Horng Liaw)

《秀傳醫學雜誌》 18卷2期 (2019/12) Pp. 157-163

https://doi.org/10.3966/156104972019121802010

摘要

臨床上，根尖病灶中的細菌可能會對鄰近的植體造成齒源性感染，演變成植體－牙髓合併病灶。即使沒有放射可透性的病變，也不代表根尖組織中不存在致病微生物。對於植體而言，周圍的失活牙都是潛在的感染來源（不論是否接受過根管治療），而且無法以X光片判讀來達到完全的術前預防。再者，即使是活牙，也有可能在植牙過程中致使其失活，進而演變出根尖病灶反過來影響植體的存活。本病例是一位61歲的女性患者，植體植入一個月後出現Sussman Type 1植體－牙髓合併病灶；內文涵蓋臨床治療步驟、牙根尖X光片的變化，最後做討論與總結。

關鍵字

根尖病灶 ； 根尖手術 ； 逆行性植體根端周圍炎 ； 植體根端病變

並列摘要

Clinically, microorganism in an apical lesion could be a potentially infectious source that could contaminate the surface of a nearby implant. We refer to this type of lesion as an implant-endodontic combined lesion. When we evaluate the risk factors of implants, adjacent devital teeth could be sources of infection, which cannot be prevented by preoperative X-ray examination. Furthermore, even vital adjacent teeth could be devitalized due to the surgical procedure of dental implantation, potentially resulting in an endodontic apical lesion that may be a hazard to the implant. In our case report, a 61-year-old female patient encountered a Sussman's type I endodontic-implant combined lesion, one month after implant insertion. This article draws conclusions about the overall clinical evolution (treatment procedure and X-ray findings), and provides a cumulative survey of related research, as well as discussion.

並列關鍵字

Endodontic apical lesion ； Apical surgery ； Retrograded peri-implantitis ； Periapical implant pathology