上顎洞に交通した上顎大臼歯髄床底穿孔の1例

抄録

Abstract : In the endodontic therapy, when perforation occur at the furcated area of multirooted tooth, the first choice is to close down from the side of the pulp floor. However, in the case of prognosis to be bad, the close down procedure from outer surface root of the tooth, separation, hemisection, and replantation will be selected.

 In this case report, the patient has the big perforation of about 3-4 mm at the furcation area of the upper first molar. The perforation part was closed down from the side of the pulp floor with the apatite cement.

 After 1 year, prognosis was bad. So we decided to try intentional replantation. After extraction, the perforation part was closed by apatite cement and the root apex was retrofilled by glass ionomer cement. At this time, the perforation between the mediobuccal root and the palatal root, and also communication of the maxillary sinus were confirmed. After irigation, curetting of this part, the tooth was replanted.

 After 1 year, the patient had no clinical symptoms.

 The treatment of the odontogenic maxillary sinusitis is extraction of the cause tooth or the sinusectomy. However, the method for this case did not spend long time for the treatment and could remove infected part easily. In addition, it was possible to preserve the tooth with intentional replantation.

 It is considered that this method is effective for odontogenic maxillary sinusitis due to perforation of the furcation area.