上顎第一大臼齒慢性根尖膿腫合併慢性鼻竇炎的治療：病例報告

Treatment of Chronic Apical Abscess Combined with Chronic Sinusitis of the Maxillary First Molar: A Case Report

張淑芳(Shu-Fang Chang)

《中華民國家庭牙醫學雜誌》 15卷2期 (2020/09) Pp. 25-32

https://doi.org/10.6566/JFD.202009_15(2).0004

摘要

上顎後牙牙根因靠近上顎竇底，根尖感染容易延伸至鼻竇而與鼻竇炎相關，因此，如果上顎後牙區有持續性的慢性膿腫有必要將慢性鼻竇炎列入治療的考慮。本文報告一個慢性根尖膿腫合併慢性鼻竇炎的非手術性根管再治療的病例。右上第一大臼齒因慢性根尖膿腫做過兩次根管治療，症狀持續存在，經轉診口腔外科拔牙。因病人想要保留牙齒而至牙髓病科評估。病人有鼻中膈彎曲合併慢性肥厚性鼻炎的病史，於四年前曾開刀治療。在根管重新治療期間，根尖膿腫依然沒有改善，會診耳鼻喉科施予功能性內視鏡鼻竇手術及鼻中膈及下鼻甲成形術治療後，根尖膿腫消失，最後以馬來膠針充填完成根管治療。十二個月後追蹤無臨床症狀，X光影像顯示根尖病灶有癒合的跡象。

關鍵字

上顎第一大臼齒 ； 慢性根尖膿腫 ； 慢性鼻竇炎

並列摘要

The roots of the maxillary posterior teeth are close to the base of the maxillary sinuses, and the infection around the apex easily extends to the sinuses. This article reports a case of non-surgical root canal retreatment with chronic apical abscess and chronic sinusitis. The upper right first molar had undergone root canal treatments twice at the dental clinic due to chronic apical abscess, but the symptoms persisted. The patient had the history of nasal septal deviation with chronic hypertrophic rhinitis and was treated with surgery 4 years ago. After consultation of ENT department, the patient received surgical treatment of functional endoscopic sinus surgery and septoturbinoplasty. Then, the sinus tract subsided and the root canal treatment of tooth 16 was performed. After 12 months follow-up, no clinical symptoms were noted. X-ray images showed the apical lesion seemed to be complete healed.

並列關鍵字

maxillary first molar ； chronic apical abscess ； chronic sinusitis