髄床底穿孔を生じた近心中央根管を有する下顎第一大臼歯に感染根管治療を行った一症例

抄録

Abstract : The success rate for treatment of perforated teeth with a periapical lesion is not high (56%). Mandibular molars are reported to have a 10-20% probability of developing a middle mesial canal (MMC), but it is difficult to detect and treat them in the clinic. We report a case of infected root canal treatment for a mandibular first molar with a MMC that had a perforated floor of the pulp chamber. A 35-year-old man presented with apical periodontitis and perforation of the pulp chamber. Perforation was located at the buccal root furcation and was in contact with the periodontal pocket. Root canal treatment with a surgical microscope was started, and the MMC was found. The perforated area was repaired with MTA, the main and MMC were shaped and cleaned, then the root canal was filled. One year after treatment, the clinical symptoms disappeared and the periapical lesion of the apex and root furcation disappeared. The perforation area could be properly identified by optical magnification and pre-treatment, and perforation repair with MTA could be performed. The MMC was found and debridement, which was necessary for the healing of apical periodontitis, was performed, with good results.