洗浄効果を用いた大型根尖病変の治療に関する考え方

抄録

Abstract : This case report describes root canal procedures and prognosis after conservative root canal treatment for three cases with large periapical lesions. The teeth involved had a phoenix abscess with spontaneous pain, a phoenix abscess with gingival swelling and pain, and a radicular cyst spreading to the adjacent tooth and sinus. Sodium hypochlorite solution (NaClO) is the best solvent agent for destruction of the epithelial lining and sub-epithelial hemorrhage of the lesion. The root canals were cleaned with both a biomechanical preparation and a biochemical preparation with sodium hypochlorite and hydrogen peroxide. The use of NaClO for conservative root canal treatment of a large apical lesion tooth promoted drainage of the pus and destruction of the epithelial lining, after which the large lesions quickly changed to granulomatous tissue from a cyst. After disinfecting the root canal, the canals were obturated with gutta-percha and sealer. Radiographic images showed the disappearance of the apical lesion and osteogenic healing, and the longest case also showed a fair course after an 18 years prognosis. This report suggested that a proper procedure using canal irrigation with a solvent agent is effective for the conservative treatment of a large periapical lesion.