上顎大臼齒額外根管之根管治療與補綴物考量：病例報告

Endodontic Treatment of the Upper Molar with MB2 Root Canal and Prosthetic Consideration: A Case Report

魏祥禮(Hsiang-Li Wei) ； 龔榮章(Jung-Chang Kung) ； 李坤宗(Kun-Tsung Lee)

《中華民國家庭牙醫學雜誌》 16卷1期 (2021/06) Pp. 26-33

https://doi.org/10.6566/JFD.202106_16(1).0004

摘要

根據文獻研究指出，在上顎第一大臼齒有額外根管的機率大約有四成六至八成八，當中的差異性取決於人種的差別，本報告是探討有額外根管的上顎第一大臼齒與上顎第二大臼齒的根管治療過程與後續補綴物贗復的選擇考量。病人主訴是左上後牙區有持續不適的情況。與病人討論後，所擬定的治療計畫為常規根管治療與使用補綴物來贗復。牙齒經根管治療後造成容易斷裂的主要原因為大量齒質的減少，所以針對根管治療後補綴物的選擇，以保留較多健康齒質為目標來考量，選擇用全瓷冠蓋體的補綴物來裝置。此種補綴物設計在無咬合不正及特殊口腔習癖前提下，相對於傳統牙套補綴物，其優點是能保留較多健康的齒質。在唾液隔離完全的情況下進行黏著，在五至十年的追蹤期間，依然保有九成九的成功率。

關鍵字

上顎第一大臼齒 ； 額外根管 ； 全瓷冠蓋體

並列摘要

According to previous literatures, the incidence rate of an extra root canal in the maxillary first molar is about 46%~88% depending on ethnic differences. This report is to discuss the procedures of root canal treatment of the maxillary first molar with secondary mesio-buccal root canal and prosthetic considerations after finishing the complete root canal treatment. This 40y/o female patient complained about persistent discomfort over the upper left posterior area. After the discussion with the patient, the treatment plan was conventional root canal treatment and prosthesis fabrication. The majority etiology of teeth fracture after root canal treatment is the mass reduction of teeth structures. After conversing as much healthy teeth structure as possible, we selected all ceramic onlay to restore the decay. Since the patient ha no oral parafunction or special oral habits, this kind of prosthesis design has the advantage of conserving more healthy tooth structures than the traditional crown.

並列關鍵字

upper first molar ； extra root canal ； all ceramic onlay