재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료
Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as Miller°Øs Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller’s Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.
Abstract
along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as Miller°Øs Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller’s Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.
참고문헌 (15)
- Leknes KN, "Cemental tear: a risk factor in periodontal attachment loss", J Periodontol, 67, pp.583~588 (1996)
- Haney JM, "Cemental tear related to rapid periodontal breakdown: a case report", J Periodontol, 63, pp.220~224 (1992)
- Harrel SK, "Treatment of periodontal destruction associated with a cemental tear using minimally invasive surgery", J Periodontol, 71, pp.1761~1766 (2000)
- Tulkki MJ, "Cemental tear: a case report of a rare root fracture", J Endod, 32, pp.1005~1007 (2006)
- Tai TF, "Persistent endodontic lesion due to complex cementodentinal tears in a maxillary central incisor--a case report", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103, pp.e55~e60 (2007)
- Chou J, "Cementodentinal tear: a case report with 7-year follow-up", J Periodontol, 75, pp.1708~1713 (2004)
- Lin HJ, "Cemental tear:clinical characteristics and its predisposing factors", J Endod, 37, pp.611~618 (2011)
- Ishikawa I, "Cervical cemental tears in older patients with adult periodontitis. Case reports", J Periodontol, 67, pp.15~20 (1996)
- Stewart ML, "Cemental tear: a case report", Int Endod J, 39, pp.81~86 (2006)
- Artzi Z, "Effect of guided tissue regeneration on newly formed bone and cementum in periapical tissue healing after endodontic surgery: an in vivo study in the cat", J Endod, 38, pp.163~169 (2012)
- Watanabe C, "Multiple cemental tears", Oral Surg Oral Med Oral Pathol Oral Radiol, 114, pp.365~372 (2012)
- Muller HP, "Cemental tear treated with guided tissue regeneration: a case report 3 years after initial treatment", Quintessence Int, 30, pp.111~115 (1999)
- Bosshardt DD, "Dental cementum: the dynamic tissue covering of the root", Periodontol 2000, 13, pp.41~75 (1997)
- Noma N, "Cementum crack formation by repeated loading in vitro", J Periodontol, 78, pp.764~769 (2007)
- Lin HJ, "Clinical fracture site, morphologic and histopathologic characteristics of cemental tear: role in endodontic lesions", J Endod, 38, pp.1058~1062 (2012)