对牙内陷诊断和治疗的再认识

Reconsideration of the diagnosis and treatment for dens invaginatus

牙内陷病变部位隐蔽、解剖结构复杂多变,给诊断和治疗带来困难。锥形束CT可以了解牙内陷复杂的三维结构,有助于明确分类,提高诊断准确性;根据牙内陷的类型、牙髓感染及牙周破坏程度、根尖孔是否闭合选择不同的治疗方案;新技术和新材料的应用有望提高牙内陷治疗的成功率。本文从牙内陷的病因到临床疗效等方面进行系统的文献回顾和分析,以期为牙内陷的临床诊断和治疗提供指导。

Dens invaginatus(DI)is a developmental dental anomaly with complicated anatomical features and a broad spectrum of morphologic variations posing challenges of diagnosis and treatment to dental clinicians.Cone-beam CT(CBCT)can provide a more detailed 3D view of the complex anatomical variations in DI and help dental clinicians to verify the classification of DI and to improve the accuracy of diagnosis.A number of treatment planning options may need to be considered based on DI types,peri-radicular pathology involved and apical orifice closure status.Applications of modern endodontic techniques and novel materials may induce successful treatments and favorable outcomes.The aim of the present article is to review the etiology,classification and treatment outcome of DI and to provide guidelines of diagnosis and management of DI cases for dental clinicians.