外傷由来で生じた炎症性歯根外部吸収の歯根端切除術による治療

抄録

Abstract : In contrast to deciduous teeth, root resorption does not normally occur in permanent teeth. However, it may be triggered by damage to the precementum on the surface of the root, causing inflammatory external root resorption. We investigated whether a patient with trauma-induced external root resorption of the maxillary lateral incisor could be successfully treated by performing endodontic micro-surgery. A 34-year-old man had undergone pulp extirpation after traumatic injury when he was young. Apical periodontitis and inflammatory external root resorption subsequently developed, and apicoectomy of the maxillary left lateral incisor was performed under surgical microscopy. The lesion and granulation tissue were removed completely, and the malacic tooth substance at the resorption site was mechanically removed. Retrograde cavity preparation was conducted, and the cavity and resorption site were filled with MTA cement. Two years post-treatment, the patient had no clinical symptoms and X-rays showed scar healing at the site of the resorption-induced bone defect. Surgical removal of the granulation tissue at the resorption site, mechanical removal of the tooth substance, and filling with a highly biocompatible cement stopped the progress of resorption and successfully saved the tooth. This case suggests that endodontic micro-surgery may be a useful treatment method for inflammatory external root resorption.