使用牙科電腦斷層掃描診斷右下顎第一大臼齒垂直牙根斷裂－病例報告

Diagnosis of Lower Right First Molar Vertical Root Fracture with Dental Computed Tomography-A Case Report

張雅琪(Ya-Chi Chang) ； 林玥玟(Yueh-Wen Lin) ； 莊孟哲(Meng-Che Chuang) ； 黃智嘉(Chi-Chia Huang)

《中華民國家庭牙醫學雜誌》 4卷4期 (2010/03) Pp. 26-33

https://doi.org/10.6566/JFD/2010.4(4).26

摘要

臨床上要診斷垂直牙根斷裂非常不容易，常因為臨床症狀、表徵和X光片影像與慢性牙周病或失敗的根管治療非常類似，進而造成診斷及治療的困擾。牙科電腦斷層攝影術最早應用在人工植牙，可以提供許多平面X光片所無法顯示的影像資訊， 如今可以藉由它幫助我們診斷垂直牙根斷裂。本病例報告是一位57歲的女士到本院牙科部求診，主訴右下顎第一大臼齒頰側牙齦最近突然疼痛，臨床檢查右下顎第一大臼齒疑似有垂直牙根斷裂，經由牙科電腦斷層掃描的影像顯示近心牙根舌側面有牙根垂直斷裂的影像。拔除牙齒後，確定在近心牙根舌側面有一道垂直裂紋與牙科電腦斷層掃描的影像吻合。本病例報告顯示使用牙科電腦斷層攝影術可以診斷垂直牙根斷裂。

關鍵字

下顎第一大臼齒 ； 牙科電腦斷層掃描 ； 垂直牙根斷裂

並列摘要

The diagnosis of vertical root fracture is, at times, difficult because of that clinical signs and symptoms as well as radiographic presentations are often similar to those associated with non-healing root canal treatments and with certain manifestations of periodontal disease. Cone-beam CT, being used first in implantology, can provide us more information than two-dimensional dental radiography and help to diagnose vertical root fracture.
This is a case report of a 57 year-old female. She complained that her lower right buccal gingiva of the first molar was painful suddenly. It was suspected as vertical root fracture clinically. The dental cone-beam CT report said that there was a fracture line at the lingual surface of the mesial root. We confirmed the fracture line after extracting her lower right first molar.
This case report support that dental cone-beam CT is superior to dental radiography in the detection of vertical root fracture.

並列關鍵字

mandibular first molar ； vertical root fracture ； dental cone-beam CT