접근이 곤란한 하악 견치 3급 와동 우식에 있어서 교정장치 MTA와 직접치수복조술을 통한 최소 침습적 치료 증례 보고
Minimally Invasive Caries Treatment of Mandibular Canine's Inaccessible Class Ⅲ Cavity Through Anterior Alignment Using Mini-Tube Appliance and Direct Pulp Capping: Case Report.
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초록
깊은 우식의 치료는 치과학이 건강하고 자연적인 치아구조와 치아 생활력을 최대한 보존하고자하는 “minimally invasive dentistry"로 발전함에 따라 더 많은 고민을 필요로 한다. 방사선학적으로 치수에 근접한 깊은 우식은 신경치료를 동반한 전장관으로 해결하거나 최대한 치수 생활력을 보존하고 직접 수복으로 치료할 수 있다. 본 증례 보고에서는 접근이 어려운 하악 좌측 견치의 원심 치경부 우식을 "minimally invasive dentistry"의 개념에 따라 접근하기 위해 교정장치 MTA를 이용한 하악 부분교정을 동반하여 상실된 치간 공간을 재확보하고 직접치수복조와 직접 수복으로 해결하였다. 이에 더해, 본 증례보고에서는 우식으로 인해 치수가 노출된 생활영구치에서 직접치수복조의 효용성과 치수 노출 위험을 줄이기 위한 보다 나은 우식 제거 방법에 대해 논하고자 한다.
Abstract
Deep caries treatment requires more and more considerations as modern dentistry has evolved to "minimally invasive" approach in which focus is on maximum conservation of healthy, natural tooth structure and preservation of tooth vitality. Deep caries, those with a lesion that reaches close to the pulp space on the radiograph, can be treated with either crown incorporated with endodontic treatment or direct restoration preserving pulp vitality as much as possible. In this case report, to approach deep caries with the minimally invasive concept, inaccessible class Ⅲ cavity of lower left canine was treated with direct pulp capping and direct restoration after regaining the interdental space through a mini-tube appliance(orthodontic MTA). In addition, the aims of this report are to discuss the efficacy of direct pulp capping(DPC) in vital permanent teeth with cariously exposed pulp and a better way to excavate deep caries to decrease the risk of pulp exposure.
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