利用顯微根尖手術處理上顎小臼齒根尖病灶合併上顎竇膜穿孔：病例報告

Treatment of the Apical Lesion of Maxillary Premolars with Maxillary Sinus Membrane Perforation by Endodontic Microsurgery: A Case Report

張智堯(Chih-Yao Chang) ； 劉季煒(Ji-Uei Liou)

《中華民國家庭牙醫學雜誌》 15卷3期 (2020/12) Pp. 31-36

https://doi.org/10.6566/JFD.202012_15(3).0005

摘要

上顎竇膜穿孔的可能原因包含上顎後牙區手術或病因性破壞等，可能會進一步導致口竇連通的狀況。本案例為一名54歲男性經環口全景X光片與錐狀射束電腦斷層攝影檢查顯示右上小臼齒根尖病灶與上顎竇連通。以非手術根管治療後未復原，所以進行顯微根尖手術，運用顯微鏡於根尖手術對於周邊組織構造傷害降至最低以提高成功率。術後追蹤一年，其臨床症狀與根尖病灶獲得明顯改善，且上顎竇炎已復原。本病例報告將提供上顎小臼齒根尖周圍炎合併上顎竇膜穿孔時臨床上的處置及探討。

關鍵字

上顎竇膜穿孔 ； 顯微根尖手術

並列摘要

Maxillary sinus membrane perforation may result from surgical or pathological destruction over maxillary posterior area, which may further leads to oroantral communication. This article is going to present a case of a 54-year-old male. The panoramic radiography and cone-beam computed tomography revealed the apical lesion over right maxillary premolars with maxillary sinus membrane perforation. Nonsurgical root canal treatment did not resolve symptoms. Therefore, the endodontic microsurgery was performed. The endodontic microsurgery minimizes the damage to the surrounding tissue and improve the success rates. After one year follow-up, his clinical symptoms and apical lesions were significantly improved, and the maxillary sinusitis had subsided. The aim of this article is to present our case and to discuss the clinical management of apical periodontitis of maxillary premolars with maxillary sinus membrane perforation.

並列關鍵字

maxillary sinus membrane perforation ； endodontic microsurgery