中国口腔医学继续教育杂志 ›› 2024, Vol. 27 ›› Issue (5): 423-430.DOI: 10.12337/zgkqjxjyzz.2024.05.006

• 病例分析 • 上一篇    下一篇

右下颌第二磨牙牛牙症伴C形根管治疗1例

林冬佳, 王阿丹, 黄芳*   

  1. 中山大学附属口腔医院,广东省口腔疾病临床医学研究中心
  • 出版日期:2024-09-30 发布日期:2025-05-09
  • 通讯作者: *黄芳,hfang@mail.sysu.edu.cn,联系方式:020-83878836,通讯地址:广东省广州市越秀区陵园西路56号,510080

The Integrated Digital Precision Treatment of Crown and Root in Low Second Molar with Taurodontism and C-shaped Root Canal System

Dongjia Lin, Adan Wang, Fang Huang*   

  1. Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Clinical Research Center of Oral Diseases
  • Online:2024-09-30 Published:2025-05-09
  • Contact: Fang Huang. Tel: 020-83878836hfang@mail.sysu.edu.cn. Address: No.56, Lingyuan West Road, Yuexiu District, Guangzhou 510055, Guangdong Province, P.R. China.

摘要: 目的:报道1例右下颌第二磨牙牛牙症伴C形根管冠根一体数字化精准治疗的病例。诊治经过:采用锥形束计算机断层扫描技术(Cone-beam Computed Tomography,CBCT)三维重建根管系统和评估根尖周病损,术前明确诊断并制定治疗方案,取得患者知情同意后,进行右下颌第二磨牙显微根管再治疗及数字化椅旁即刻全冠修复。结果:右下颌第二磨牙术后根尖片示根充恰填。1年随访,患者未诉不适,CBCT示右下颌第二磨牙根尖周骨密度影增高。结论:牛牙症伴C形根管系统临床较为罕见,治疗难度较高。本病例贯彻术前CBCT三维重建根管形态特征和评估根尖周病损程度;术中手术显微镜逐级放大系统实现根管口的精准定位和可视化操作;术后个性化椅旁即刻修复设计实现冠修复设计与根管系统特点相结合的冠根一体化治疗理念,取得长期稳定的临床效果。

关键词: C形根管系统, 牛牙症, 慢性根尖周病损, 冠根一体化治疗, 个性化椅旁即刻修复技术

Abstract: Objective: This paper aims to report a case of integrated digital precision treatment of crown and root in low second molar with taurodontism and C-shaped root canal system. Diagnosis and treatment: After 3D reconstruction of root canal system and assessment of periapical lesions by dental Cone-beam Computed Tomography(CBCT), the definitive diagnosis was achieved. Obtaining the informed consent of the patient, micro-root canal retreatment and chairside computer aided design/computer aided manufacture(CAD/CAM) technique were performed. Results: After one-year follow-up, the patient had no symptoms. CBCT showed that the low second molar root obturation was filled in three dimensions, and the bone density in the apical area increased. Conclusions: Taurodontism of mandibular second molar with C-shaped root canal is rare and difficult to treat. In this case, the root canal system and periapical lesion were analyzed by preoperative CBCT 3D reconstruction. During the operation, dental microscope was used for step-by-step magnification and excellent lighting function to achieve accurate positioning of the root canal opening and visual operation. After retreatment, CAD/CAM technique realized the concept of crown and root integration, which combined the crown design with the characteristics of the root canal system, and finally achieved long-term stable clinical treatment effect.

Key words: c-shaped root canal system, taurodontism, periapical lesion, crown and root integration, computer aided design/computer aided manufacture (CAD/CAM) technique