Case report and literature review of vital pulp preservation by endodontic microsurgery at the distal buccal root of maxillary molar
10.12016/j.issn.2096⁃1456.2020.11.008
- Author:
TAN Xuelian
1
,
2
,
3
;
NING Jiali
1
,
2
,
3
;
XU Weizhe
1
,
2
,
3
;
WANG Liu
1
,
2
,
3
;
ZHANG Lan
1
,
2
,
3
;
ZHENG Guangning
1
,
2
,
3
;
HUANG Dingming
1
,
2
,
3
Author Information
1. State Key Laboratory of Oral Diseases &
2. National Clinical Research Center for Oral Diseases &
3. Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University
- Publication Type:Journal Article
- Keywords:
vital pulp preservation;
periapical disease;
dental pulp origin;
endodontic microsurgery;
laser doppler flowmetry;
mineral trioxide aggregate;
cemental hypoplasia
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2020;28(11):723-727
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnosis, treatment and prognosis of nonodontogenic periapical lesions and to provide a reference for clinical diagnosis and treatment.
Methods: A case of a patient with right upper molar pulp with apical penetration and local occlusion admitted to the West China Stomatological Hospital of Sichuan University was retrospectively analyzed, and the curative effect of microapical surgery and pith preservation was also analyzed.
Results :The imaging features of tooth 16 showed periradicular radiolucency combined with local radiopaque lesions around the distal buccal apical area. Endodontic microsurgery was performed under local anesthesia. Soft tissue coverage was observed in the distal buccal apical area during the surgery, and no radiopaque tissue was detected. The distal buccal root apex was cut by 3 mm, and mineral trioxide aggregate was used for root-end backfilling. The postoperative pathological results revealed fibrous connective tissue. One-week recall X-ray examination showed tight root-end backfilling and no periradicular radiolucency; an electrical test of pulp vitality showed positive results. The four-year follow-up showed that there was no discoloration in tooth 16 and no significant difference in thermal and electrical tests of pulp vitality compared with control teeth. Combining the clinical manifestations, imaging features, surgical exploration results and pathological reports, the case was most likely to be cemental hypoplasia. Through the literature review, the treatment and healthy pulp preservation of such cases by endodontic microsurgery under the premise of preserving teeth has not been reported.
Conclusion:For maxillary posterior teeth with periapical lesions but healthy pulp, accurate estimation of pulp status, endodontic microsurgical exploration and application of bioactive materials can achieve vital pulp preservation while removing the lesions.
- Full text:上颌磨牙远颊根行显微根尖外科手术保存活髓病例报告及文献复习.pdf
