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J Endod：非手术疗法治疗较大尖周或囊性损伤伴随根尖孔开放的牙根：一项病例汇报

2017-11-01 lishiting MedSci原创

根尖损伤囊性病变根尖孔开放保守疗法
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根尖开放的牙齿缺少自然的根尖收缩形态。这对于常规的牙髓治疗，特别是为了建立根尖封闭带来诸多挑战。另外，当此类牙齿伴随较大尖周或囊性损伤时，治疗也同样增加难度，疗效常导致临近骨皮质膨胀和/或变薄。尽管此类疾病常采用外科手术的疗法，但医师们更希望能出现一种可获得同样良好预后的保守疗法。

根尖开放的牙齿缺少自然的根尖收缩形态。这对于常规的牙髓治疗，特别是为了建立根尖封闭带来诸多挑战。另外，当此类牙齿伴随较大尖周或囊性损伤时，治疗也同样增加难度，疗效常导致临近骨皮质膨胀和/或变薄。尽管此类疾病常采用外科手术的疗法，但医师们更希望能出现一种可获得同样良好预后的保守疗法。这篇系列病例报道包含3份病例：1个39岁的女性、1个45岁的男性和1个15岁的男孩，他们的牙齿均伴随着根尖孔开放以及较大的尖周/囊性损伤，并通过以下步骤进行保守治疗：(1) 根管内严格的消毒，(2)采用数字减压技术在根管内吸引相关的肿胀，(3) 1步法根尖诱导成形术通过初级富含血小板纤维蛋白屏障(PRF)和次级生物牙本质屏障(Septodont， Saint-Maur-des-Fossés， France)封闭根尖孔。在所有3个病例中，临床和放射线影像检查的治疗效果均十分令人满意。PRF和生物牙本质均为根尖孔填塞剂，已有研究证实它们均为1步法根尖诱导成形术中常规用药MTA的适宜替代品。生物牙本质具有羟基磷灰石晶体沉积的特性，可以在材料-牙本质界面为牙本质提供良好的界面粘附和封闭作用。同样，由于其所具有的生物活

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    2018-02-27 wolongzxh

    #囊性#

    0

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    2018-08-27 124987c6m43暂无昵称

    #根尖孔#

    0

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    2017-12-25 passed water

    #病例汇报#

    0

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    2017-11-03 ms3046638856685384

    #损伤#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1675849, encodeId=d50716e5849f2, content=<a href='/topic/show?id=7395403e580' target=_blank style='color:#2F92EE;'>#囊性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40375, encryptionId=7395403e580, topicName=囊性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=926927300775, createdName=wolongzxh, createdTime=Tue Feb 27 22:57:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1635501, encodeId=c889163550118, content=<a href='/topic/show?id=e2466219828' target=_blank style='color:#2F92EE;'>#根尖孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62198, encryptionId=e2466219828, topicName=根尖孔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a0e22484117, createdName=124987c6m43暂无昵称, createdTime=Mon Aug 27 13:57:00 CST 2018, time=2018-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2006987, encodeId=04c8200698ea6, content=<a href='/topic/show?id=93dfe0782a6' target=_blank style='color:#2F92EE;'>#病例汇报#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70782, encryptionId=93dfe0782a6, topicName=病例汇报)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/72D57F5B3E12B2BB53D6BD015D14DCD6/100, createdBy=a92e2500162, createdName=passed water, createdTime=Mon Dec 25 00:57:00 CST 2017, time=2017-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397368, encodeId=27ad139e36860, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Fri Nov 03 11:57:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627972, encodeId=e132162e972de, content=<a href='/topic/show?id=49406e574ae' target=_blank style='color:#2F92EE;'>#牙根#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67574, encryptionId=49406e574ae, topicName=牙根)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5ff21139121, createdName=zhu_jun9844, createdTime=Fri Nov 03 11:57:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258158, encodeId=8ace25815870, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Thu Nov 02 22:21:45 CST 2017, time=2017-11-02, status=1, ipAttribution=)]
    2017-11-03 zhu_jun9844

    #牙根#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1675849, encodeId=d50716e5849f2, content=<a href='/topic/show?id=7395403e580' target=_blank style='color:#2F92EE;'>#囊性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40375, encryptionId=7395403e580, topicName=囊性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=926927300775, createdName=wolongzxh, createdTime=Tue Feb 27 22:57:00 CST 2018, time=2018-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1635501, encodeId=c889163550118, content=<a href='/topic/show?id=e2466219828' target=_blank style='color:#2F92EE;'>#根尖孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62198, encryptionId=e2466219828, topicName=根尖孔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a0e22484117, createdName=124987c6m43暂无昵称, createdTime=Mon Aug 27 13:57:00 CST 2018, time=2018-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2006987, encodeId=04c8200698ea6, content=<a href='/topic/show?id=93dfe0782a6' target=_blank style='color:#2F92EE;'>#病例汇报#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70782, encryptionId=93dfe0782a6, topicName=病例汇报)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/72D57F5B3E12B2BB53D6BD015D14DCD6/100, createdBy=a92e2500162, createdName=passed water, createdTime=Mon Dec 25 00:57:00 CST 2017, time=2017-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397368, encodeId=27ad139e36860, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Fri Nov 03 11:57:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627972, encodeId=e132162e972de, content=<a href='/topic/show?id=49406e574ae' target=_blank style='color:#2F92EE;'>#牙根#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67574, encryptionId=49406e574ae, topicName=牙根)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5ff21139121, createdName=zhu_jun9844, createdTime=Fri Nov 03 11:57:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258158, encodeId=8ace25815870, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Thu Nov 02 22:21:45 CST 2017, time=2017-11-02, status=1, ipAttribution=)]
    2017-11-02 方舒

    学习

    0