Retreatment and aesthetic restoration of maxillary incisor with calcified root canal using a dynamic navigation system: a case report.

IF 2.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE BMC Oral Health Pub Date : 2024-11-08 DOI:10.1186/s12903-024-05118-4
Peng Xue, Qiang Luo, Yang Huang, Meng Xu, Lele Qiu, Jiazhu Wang, Huixia He, Fei Chen
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Abstract

Background: Pulp canal occlusion (PCO) increases the difficulty of root canal treatment as well as tooth preservation and restoration. This is the first case report of successful localization of a calcified root canal under the guidance of a dynamic navigation system (DNS) for complete root canal retreatment and aesthetic restoration after a failed attempt to locate the calcified root canal with a traditional dental operating microscope (DOM).

Case presentation: The patient was scheduled for root canal treatment for a labially inclined maxillary central incisor and post-core crown restoration with resin veneers in another hospital, but the calcified root canal could not be located with a microscope, so the patient was referred to our department. Root canal retreatment was planned for tooth #8, and the calcified root canal of tooth #9 was planned to be located and dredged under the guidance of a DNS. We used a DNS for successful positioning and to complete the root canal retreatment operation in the following 4 steps: preoperative CBCT imaging, preoperative plan design, calibration and registration, and real-time dynamic navigation. Three months later, teeth #8 and #9 presented no clinical symptoms, after which the fiber post-cores and zirconia all-ceramic crown restorations were completed. At the 12-month follow-up visit, the patient continued to be symptom-free, and satisfied with the final aesthetic restoration.

Conclusions: This case report suggests that DNS may be a promising technique with high accuracy and effectiveness to reduce the risk of iatrogenic errors and provide maximal preservation of dentin, when the traditional treatment of calcified root canals approaches failure (lateral perforation).

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使用动态导航系统对钙化根管的上颌门牙进行再治疗和美学修复:病例报告。
背景:牙髓管闭塞(PCO)增加了根管治疗以及牙齿保存和修复的难度。这是首例用传统牙科手术显微镜(DOM)定位钙化根管失败后,在动态导航系统(DNS)引导下成功定位钙化根管,完成根管再治疗和美学修复的病例报告:患者原计划在另一家医院进行唇侧倾斜上颌中切牙的根管治疗和树脂贴面后牙冠修复,但用显微镜无法找到钙化的根管,因此患者被转诊至我科。计划对 8 号牙进行根管再治疗,并计划在 DNS 的指导下对 9 号牙的钙化根管进行定位和疏通。我们使用 DNS 成功定位,并通过以下 4 个步骤完成了根管再治疗手术:术前 CBCT 成像、术前计划设计、校准和注册以及实时动态导航。三个月后,8 号牙和 9 号牙没有出现临床症状,随后完成了纤维后牙冠和氧化锆全瓷牙冠修复。在 12 个月的随访中,患者仍无症状,并对最终的美学修复效果表示满意:本病例报告表明,当传统的钙化根管治疗接近失败(侧方穿孔)时,DNS可能是一种很有前途的技术,具有高准确性和有效性,可以降低先天性错误的风险,最大限度地保留牙本质。
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来源期刊
BMC Oral Health
BMC Oral Health DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.90
自引率
6.90%
发文量
481
审稿时长
6-12 weeks
期刊介绍: BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.
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