J Endod:冠内引导技术实施的磨牙改良引导性牙髓治疗

2019-05-24 lishiting MedSci原创

这篇病例汇报的目的是为了评估一例使用引导性技术对具有受限牙合间隙的上颌第一磨牙实施牙髓治疗。引导性牙髓治疗技术包含整合CBCT影像和牙齿表面扫描以创建一个指示表面闭塞根管钻孔通道的导板。磨牙区域的牙合间隙较小,无法同时容纳导板、钻针和机头。因此,作者实施了一定的改良。

这篇病例汇报的目的是为了评估一例使用引导性技术对具有受限牙合间隙的上颌第一磨牙实施牙髓治疗。引导性牙髓治疗技术包含整合CBCT影像和牙齿表面扫描以创建一个指示表面闭塞根管钻孔通道的导板。磨牙区域的牙合间隙较小,无法同时容纳导板、钻针和机头。因此,作者实施了一定的改良。一名52岁的男性患者上颌磨牙(#3)在之前的牙髓治疗中医师无法定位远颊根管(根尖有病变)。打开髓腔及上障后,使用10号手用锉针建立近颊第一和第二根管及腭根管的顺滑通道,并将其冠方敞开。进一步使用reciprocating file size 25进行工作长度的预备。3个根管充填氢氧化钙。对于远颊根管,即使在手术显微镜的帮助下也难以定位,因此采取了引导性牙髓治疗以避免对牙齿过度损伤。从CBCT影像及表面扫描获得整合数据后,含有一个代表合适钻针通路套管的半透明SICAT Optiguide (SICAT, Bonn, Germany)制作完成,以到达远颊根管。开髓窝洞使用光固化复合材料暂封。在光固化前,取代牙齿上的Optiguide,将一个不锈钢针压入套管和复合材料内,以使适宜的钻孔通道转移至复合材料中。聚合收缩后,从含复合材

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    2019-10-10 jxrzshh
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