裂齒症合併根管內斷離器械之下顎第二大臼齒之非手術性根管再治療－病例報告

Non-surgical Retreatment of a Cracked Mandibular Second Molar with Separated Instruments - A Cases Report

張淑芳(Shu-Fang Chang)

《中華民國家庭牙醫學雜誌》 12卷3期 (2017/12) Pp. 42-48

https://doi.org/10.6566/JFD.201712_12(3).0005

摘要

決定根管治療成功的因素包括術前正確的診斷與治療計畫、術中確實的根管清創與修形、緻密的根管充填與術後適當完整的冠部補綴。本篇報告一40歲女性，具C型根管的下顎第二大臼齒，合併有裂齒症及根管內斷離器械之非手術性根管再治療的複雜病例，在牙科顯微鏡的輔助下，使用超音波器械移除牙根釘柱、舊有充填材料及斷離器械，經過完全的清創修形及充填後完成根管治療，術後觀察無任何症狀且牙周檢查正常，遂以全覆蓋牙冠復之。經過一年追蹤，臨床上並無任何不適並且維持正常咬合功能。所以在正確的診斷、輔以適當的儀器設備，在有經驗的牙醫師小心謹慎的治療之下，即使是複雜的病例，也能得到良好的治療效果。

關鍵字

C型根管 ； 裂齒症 ； 斷離器械

並列摘要

Successful root canal treatment depends on the accuracy of the diagnosis and treatment plan, complete disinfection, ideal filling quality and the fitting coronal restoration. This report describes the non-surgical root canal retreatment of a complicated case of a mandibular second molar. A 40-year-old patient presented with chewing pain on the lower left second molar. Previously root canal treated and symptomatic apical periodontitis were impressed. After old filling material removed, a crack line in the crown portion, C- shaped canal system and separated instruments were noted under microscopic observation. Root canal retreatment was performed by using the ultrasonic tip vibration and under dental microscope magnification to remove of the post and fractured instruments, then totally debride the root canals. Finally, the tooth had full coverage crown restored. Accurate diagnosis, good experience and appropriate armamentariums enable successful management of the complicated cases.

並列關鍵字

C-shaped canal system ； cracked tooth ； separated instruments