以蓄意再植術治療齒源性皮膚竇管－病例報告

Intentional Replantation in C-shaped Molar with Oral Cutaneous Sinus Tract-A Case Report

歐雅綺(Ya-Chi Ou) ； 張起華(Chi-Hua Chang) ； 姚宜仁(Yi-Jen Yao)

《臺灣口腔顎面外科學會雜誌》 31卷1期 (2020/03) Pp. 70-79

摘要

蓄意再植術是手術治療的一種，是指使用無創方式拔牙後，於口外做治療後再重新植入拔牙窩內，可以解決因牙齒位置或構造導致操作不易，或者是鄰近重要解剖構造而無法進行手術的案例。齒源性皮膚竇管是少見且不易診斷的病症。大部分的竇管經由非手術性根管治療就能獲得改善，但有少數牙齒需要進行手術治療。本病例為左側下顎的皮膚竇管，經口內外檢查配合錐狀射束電腦斷層掃描，顯示來源是左下第二大臼齒，且確認患齒為C型態根管。經過非手術性治療但症狀並未改善，接著使用蓄意再植術成功使竇管消失，僅於皮膚表面留下輕微凹陷。術後追蹤20個月，竇管並未復發，但於皮膚表面形成疤痕。

關鍵字

齒源性 ； 皮膚竇管 ； C型態根管 ； 蓄意再植術

並列摘要

Intentional replantation is an alternative surgical procedure for teeth with difficulty to treat by traditional methods due to the limitations of instrument access or the proximity of anatomical structures. Oral cutaneous sinus tracts are uncommon and may be misdiagnosed easily. Most cases can be resolved by conventional root canal treatment. However, in some case, surgical intervention will be needed. This case is an oral cutaneous sinus tract on the chin. After oral examination, the origin was assumed to be lower left second molar with C-shaped canals, which was identified by cone-bean computed tomography scan. After conventional root canal treatment, the sinus tract still persisted. Therefore, intentional replantation was arranged for surgical intervention. The sinus tract disappeared after intentional replantation but left a scar on the skin.

並列關鍵字

Cutaneous sinus tract ； C-shaped canals ； Intentional replantation