Type III 치내치의 보존적 근관치료 : 증례보고
Conservative Endodontic Treatment of Type Ⅲ Dens Invaginatus : Case Report
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치내치란 치아 조직의 석회화가 일어나기 이전에 법랑기가 치유두 내로 함입되어 나타나는 발육성 이상을 말한다. 치내치는 임상적, 방사선학적으로 다양한 변이를 나타내며, 치내치의 여러 분류법 중 Oehlers(1957)가 제안한 분류법이가장 널리 이용되고 있다. 치수는 건강한 채로 남아 있으나 함입부가 치주염과 연관된 Type III 병소를 치료하는데 다양한 술식들이 설명되어져왔다. 가장 우선시 되어야 하는 목표는 가능하다면 치수를 건전하게 보존하는 것이며, 치수질환의 명백한 증거가 없다면, 함입부를치근과 별개로 치료하는 보존적인 접근법이 필요하다. 그러나, Type III 치내치의 근관치료는 근관과 함입의 충분한 잔사제거, 재현가능한 근관장의 조절, 일관된 충전등을 충분히 달성하기 어렵다는 문제점이 있다. 본 증례는 치근단 병소를 보이는 Type III 치내치의 치료에 함입부에만 제한된 보존적 근관치료 및 Mineral TrioxideAggregate(MTA)를 이용한 폐쇄를 통해 양호한 결과를 얻었기에 보고하는 바이다.
Abstract
Dens invaginatus is a developmental anomaly resulting from an infolding of the enamel organ into the dentalpapilla prior to calcification of the dental tissue. Clinical and radiographic presentation of dens invaginatus shows a lot of variation. The classification proposedby Oehlers(1957) is most commonly used among classifications of dens invaginatus. Several treatments have been suggested to treat Type Ⅲ dens invaginatus where the pulp remains healthybut the invagination is associated with a periodontitis. The top priority objective is to preserve pulp as sound aspossible. Thus, if there is no definite evidence of pulpal disease, the conservative access which treat invaginationas distinct from the pulp is necessary. But, Endodontic treatment of Type Ⅲ dens invaginatus has the particular problems associated with achievingadequate chemomechanical debridement of the root canal system and invagination, predictable length controland consistent filling. In this case report, the endodontic treatment limited within invagination was performed for treatment of TypeⅢ dens invaginatus, and filling with Mineral Trioxide Aggregate(MTA) resulted in good prognosis.
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