下顎第二大臼齒牙髓治療失敗後之蓄意再植術

Intentional Replantation of a Mandibular Second Molar after Failure of Endodontic Treatment

葉沛盈(Pei-Ying Yeh) ； 李雅玲(Ya-Ling Lee) ； 楊淑芬(Shue-Fen Yang)

《北市醫學雜誌》 4卷1期 (2007/01) Pp. 89-94

https://doi.org/10.6200/TCMJ.2007.4.1.11

摘要

蓄意再植術(intentional replantation)是將經過根管治療的牙齒拔出，於口外治療處理後，再植回原來的齒槽中，以矯正或補救在臨床上或放射線影像上明顯可見的治療失敗。本病例患者為－33歲男性，其左下顎第二大臼齒經過非手術性根管再治療後五個月，出現牙周膿腫和瘻管等症狀，故施行蓄意再植術，術後16個月的追踪檢查顯示：病人無臨床症狀，原有放射線影像上之巨大根尖病灶也完全癒合，同時做上新的牙橋，恢復咀嚼功能。本文並對此一治療方式做文獻回顧，列出其在現代根管治療中之適應症、成功率及預後，提供作為傳統根管治療或根尖手術治療失敗時的另一選擇。

關鍵字

蓄意再植術 ； 根尖牙周炎 ； 牙根外吸收

並列摘要

Intentional replantation is the purposeful extraction and reinsertion of an endodontically treated tooth into its socket to correct a clinical or radiographic endodontic failure. It should be limited to those cases in which routine non-surgical or surgical endodontic treatment has failed. This article reported a case of a mandibular second molar that intentional replantation was performed after failure of non-surgical endodontic retreatment. The tooth was well functioned with new prosthesis and the large periapical lesion had healed completely at 16-months recall. Eighty percent success rate in five years can be expected through careful case selection and preservation vitality of PDL cells in the procedure.

並列關鍵字

intentional replantation ； apical periodontitis ； external root resorption