萌出前牙冠内病损开窗微创治疗1例伴术后随访4年

Constant observation for four years after minimally invasive therapy of pre-eruptive intracoronal lesion

目的通过1例萌出前牙冠内病损开窗微创治疗伴术后随访4年的病例报道,总结讨论此类患者的治疗经验。方法患儿,女,6岁,因龋齿就诊拍摄X线片发现左下第一磨牙萌出前牙冠内病损。该病例从初诊发现后定期检查,约9个月后患牙位于龈下,遂予局部麻醉开窗暴露患牙,微创去尽侧壁软化牙本质,保留近髓部分软化牙本质,远中髓角行直接盖髓术,术后4年定期复查并根据需要更换充填材料。结果患牙牙髓成功保存,牙根发育良好。结论萌出前牙冠内病损治疗暂无相关诊疗规范,但拍摄X线片发现隐匿疾病,并在牙冠暴露于口腔可能发生感染前及时处理,对此类患牙的远期预后具有非常重要的作用。

Objective To report a constant observation for four years after minimally invasive therapy of pre-eruptive intracoronal lesion,and to summarize the treatment experience for the patients.Methods A pre-eruptive intracoronal lesion in an unerupted permanent molar of a 6-year-old child was found upon radiographic examination prior to regular treatment.The affected tooth was exposed under local anesthesia after 9 months periodic examination when it was located under the gingiva.Minimal removal of soft dentine was taken and the direct pulp capping was performed.Periodic review was conducted for 4 years after the operation and the filling material was replaced as required.Result The pulp of the affected tooth was successfully preserved and the root of the tooth was well developed.Conclusions There is no relevant diagnosis and treatment standard for such cases as we reported.However,early diagnosis and timely treatment before the exposure to the oral cavity are very important for the long-term prognosis of such affected teeth.