上颌尖牙双根管1例

患者男 ,77岁 ,因左侧上颌前牙唇侧小包 1月于 2 0 0 1- 0 8就诊。检查 :2 1,2 2牙体完好 ,无牙周病及根尖周病 ,2 4 ,2 5 ,2 6 ,2 7,2 8缺失 ;2 3龋坏 ,髓腔暴露 ,探痛 (- ) ,冷刺激 (- ) ,叩痛 (- ) ,无松动 ,牙冠缺损面水平微倾向舌侧 ,唇侧牙龈距龈缘约 4ｍｍ处 ,见一窦道孔假性愈合 ,呈一直径约 1ｍｍ的肉芽肿 ,质韧 ,无压痛。诊断 :2 3慢性根尖周炎 ,拟行根管治疗术。根管预备时 ,发现一根管稍偏唇侧 ,初始扩大针 (采用Ｋ型扩大钻 ) 2 0号顺利进入约 2 6ｍｍ后 ,舌侧根管插入的 15号扩大针只能达到 2 1ｍｍ(图 1,根管充填前 )。表明唇…     

左侧上颌尖牙双根管1例

熟悉并掌握牙髓腔与根管的解剖结构特点是完成根管治疗的重要基础^[1]。上颌尖牙多为单根,在临床治疗中容易忽略多根管的存在。下面介绍1例上颌尖牙双根管病例。     

下颌尖牙双根1例

患者男,58岁。左下颌尖牙为孤立牙,明显松动,要求拔除。检查:上颌无牙牙合,下颌3存在,其余缺失。3松动Ⅱ度,叩痛(±),牙龈红肿( ),无溢脓,牙根外露,牙颈部楔状缺损。诊断为慢性松动性牙周病。局麻下拔除3,颊、舌两根明显,颊侧根长于舌侧根,根分叉明显,分叉部位位于根1/2处。牙槽窝内牙槽间隔明显。下颌尖牙双根1例@孙立刚$黑龙江省鸡西市发电厂医院口腔科!鸡西(158100)双根;;下颌尖牙     

左上颌尖牙S形单根双根管伴根侧囊肿1例

根管治疗已经成为治疗牙髓病、根尖周病的主流方法。根管治疗失败的最主要原因是对根管解剖形态了解不足[1-3]。完善的根管治疗一定是建立在充分了解根管解剖形态的基础上,应着重关注根管可能存在的变异。对于尖牙单根双根管的病例报告多出现在下颌尖牙,概率为4%[1,2]。上颌尖牙多为单根管,出现双根管概率较低[3]。笔者遇到1例左上颌尖牙牙根成"S"形、单根双根管、伴有根侧囊肿,查阅相关文献,无类似报导,现报告如下。     

下颌尖牙双根1例报告

病例　患者 ,女 ,67岁 ,上颌牙及下颌后牙缺失要求修复治疗。口腔内检查 :7- 77- 4 2 1- 14 - 7缺失 ,| 3远中邻面颈部深龋 ,探痛 ,无松动 ,无叩痛 ,牙片显示 | 3为双根 (图 1) ,根尖无阴影。 3 |远中邻面浅龋 ,无松动 ,牙片显示 3 |亦为双根。余无异常发现。诊断 :上颌牙列缺失 ,下颌牙列缺损 ,3 | 3龋(均为双根牙 )。治疗　 | 3去龋尽 ,开髓 ,测出唇舌向根管长均为 2 2ｍｍ ,两分根行根管治疗 ,后螺纹钉 ,光固化修复。 3 |去龋尽 ,光固化树脂修复。上半口义齿与下颌复托修复。下颌复托设计 ,舌侧铸造舌杆 ,3 | 3于舌侧窝置指支托 ,颊侧单…     

下颌尖牙双根管1例

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下颌尖牙双根管1例

患者女,60岁。因下颌切牙缺失至我院修复科要求固定修复,患者自觉3略有咬合不适感。修复科建议先行3根管治疗。查3近中邻面玻璃离子充填,叩诊无不适,冷诊无疼痛。X线片显示3根尖有阴影,直径约0.5cm。诊断为3慢性根尖周炎。常规开髓,发现颊、舌向两个根管口,光滑髓针探察发现是2个独立的根管。拍X线片显示:3两根牙胶距离较近,呈平行排列,牙胶尖端距根尖孔0.5mm。3颊侧复诊时患者无不适主诉,常规根充,澳汞充填。两周后以其为基牙行固定修复,随访8个月,无不适主诉。本病例显示,下颌尖牙为双根管,临床极为罕见。临床医生在治疗下颌尖牙时,应警…     

下颌尖牙双根1例

<正>1病例报告患者,女,76岁,因口腔修复需要来本院要求拔出左下尖牙。检查:唇倾,未探及明显龋损,松Ⅱ°,叩(-),冷热诊(-)。唇舌侧牙龈萎缩,牙结石Ⅱ°。诊断:牙周炎。治疗:患者否认拔牙禁忌症,遂行常规消毒2%利多卡因局麻下完整拔除患牙。拔牙后发现患牙为唇舌向双根(图1A)。牙体细长,牙冠轴面形态正常,唇舌径大于近远中径,牙尖磨耗至切缘平坦(图1B)。切缘最高点至唇舌侧根尖长度分别为20.5mm、18.5 mm。牙根1/2处出现根分叉,分为唇、舌二根。唇     

下颌尖牙双根1例

患者,女,67岁,因"右下颌前牙松动3月"就诊.检查:C3切端及C4(牙合)面磨耗较重,牙龈萎缩,牙根暴露约1/2,轻度叩痛,松动3°,牙周袋深10 mm.诊断:C34牙周炎.局麻下完整拔除C3C4,见C3牙根自根1/3处分为唇舌两根,呈分叉状,见图1.     

右下颌尖牙双根管1例

下颌尖牙一般为单根单管,双根管极少。笔者报告1例回族双根管型下颌尖牙。     

Bilateral congenitally missing maxillary canines. A case report

Exclusive aplasia of maxillary permanent canines is extremely rare. There are only a few cases of this condition reported in the literature. This paper reports a case of bilateral congenitally missing canines in a healthy 11 year old male of Chinese origin. The article discusses problems in diagnosis and presents options in the management of such a case. The management option selected was the most appropriate for the family at the time of presentation.     

Bifurcation, birooted primary canines: a case report

A rare case of birooted primary canines is reported. A male patient aged 6 years 4 months of age presented with pain and swelling related to the upper right first primary molar. Radiographic examination revealed an incidental finding of bifurcation of the roots of all four primary canines. This represents a rare finding. The prevalence of birooted permanent canines in the Japanese population has been reported, but the prevalence of this abnormality of primary canines in other populations is unknown. This report discusses the findings in the context of the available literature. The possible aetiology, possible inferences for the developing dentition, and the need for careful assessment prior to root canal therapy or extraction are highlighted.     

上颌埋伏尖牙非手术助萌的正畸治疗

[摘要] 目的 探讨上颌埋伏尖牙非手术助萌正畸治疗的适应证及其临床效果。方法 选取10～15岁上颌埋伏尖牙患者20例,应用螺旋CT三维重建技术对其进行诊断,明确埋伏尖牙颌骨内位置、方向及牙根发育情况,选取适合病例12例通过正畸手段为埋伏尖牙开辟间隙,等待其自行萌出;8例采用外科翻瓣导萌术牵引导萌。结果 12例非手术助萌患者,正畸拓展足够间隙后经3～10个月上颌埋伏尖牙均自行萌出至正常位置,牙周附着健康;8例外科手术导萌患者,上颌埋伏尖牙正畸牵引到位后均有不同程度的牙周附着丧失,影响龈缘美观。结论采用螺旋CT三维重建技术可以立体直观的提供埋伏尖牙的信息,为临床医师明确诊断及制定治疗方案提供依据,减少手术适应证,使用非手术助萌的方法可使上颌埋伏尖牙自行萌出,避免手术创伤痛苦,萌出后牙周附着好。     

Permanent maxillary canines – review of eruption pattern and local etiological factors leading to impaction

The position of the permanent maxillary canine at the angle of the mouth is strategically significant in maintaining the harmony and symmetry of the occlusal relationship. However, the maxillary canine is the second most frequently impacted tooth, with prevalence reported to be between 1% and 2%. Moreover, treatment of this condition is often complex and involves substantial time and financial cost. Hence, it is only prudent to monitor the eruption and identify the etiological factors that lead to impaction of the maxillary canine. Numerous researchers have tried to identify specific and nonspecific etiological factors responsible for displacement of canines. The purpose of this review was to track the development processes of maxillary canines and determine the hindrances that affect the eruption at different ages. Awareness of the eruption process and etiology of noneruption will help to reduce the incidence of impacted canines by allowing for early recognition and interceptive treatment.     

A six-canal maxillary first molar: case report

AIM: The aim of this case report is to describe an unusual six-canal maxillary first molar tooth. CASE REPORT: The maxillary left first molar of a young African-American male was treated as an emergency at the first visit. At the second visit, the five canals (MB1 and 2, Pal1 and 2 and DB) were easily identified at high magnification of 16-25 under an operating microscope. The canals were then instrumented and filled using the Microseal technique. A careful radiographic examination of the final fill indicated that there was a third canal in the palatal root as suggested by a slight extrusion of the filling material between the two canals. At the third visit, the fillings of the palatal canals were removed and the apical 4mm was re-examined. The existence of a third palatal canal exiting between the two apices was verified and subsequently instrumented and obturated. KEY LEARNING POINTS: It should be assumed that all molar teeth have more than the traditionally expected three canals. The location of root canals should be identified at high magnification under the microscope. Careful radiographic re-examination of the fillings should be done in order to identify possibly missed canals.     

上颌阻生尖牙患者寰椎形态变异情况的锥形束CT研究

目的 利用锥形束CT(cone-beam computed tomography,CBCT)研究上颌尖牙唇(腭)侧阻生(BIC/PIC)的患者寰椎形态变异的发生情况,以期辅助上颌阻生尖牙的预测和早期干预。方法 选取196例上颌阻生尖牙患者(研究组)和196例年龄、性别、安氏分类与之相匹配的尖牙正常萌出者(对照组)。将所有样本的CBCT导入Dolphin软件,重建头颅侧位片和三维图像,观察并记录各组寰椎后桥及寰椎后弓发育缺陷(包括寰椎后弓发育不全和寰椎后椎弓裂隙)的发生情况,并使用SPSS软件进行统计分析。结果 研究组寰椎后桥的发生率为32.6%,显著高于对照组(22.4%,P=0.024)。PIC组寰椎后桥发生率显著高于对照组(P=0.005),BIC组和对照组、BIC和PIC组之间无统计学差异(P>0.05)。寰椎后弓发育缺陷研究组和对照组之间的发生率并无统计学差异(P>0.05)。结论 上颌尖牙阻生患者较尖牙正常萌出者更容易发生寰椎后桥。     

A hollow-bulb interim obturator for maxillary resection. A case report

The treatment of hemimaxillectomy patients include the construction of an interim obturator in the wound healing period. With the aim of simplifying this process, we describe construction of an obturator in a short single visit, in the dental chair with no need for impressions or for laboratory services. The obturator comprises: (i) the surgical obturator and (ii) a hollow light-cured resin bulb built onto the base, and providing a large surface for bonding of the soft reline material. The advantages of this approach are rapid construction and ease of ongoing adjustment during the healing process.     

The etiology of palatal displacement of maxillary canines

Palatal displacement of maxillary canines occurs with greater frequency in patients with certain genetically determined abnormalities, including peg-shaped, reduced and congenitally missing lateral incisors. One view is that the canine aberration is similarly genetically determined, while a second view is that the genetically determined anomalies of the lateral incisors provide an environment that deprives the erupting canine of its normal guidance. Earlier work has shown that canine displacement occurs more frequently in patients with peg-shaped or reduced lateral incisors than in those with missing lateral incisors, which has been explained away by variability due to gene penetrance and individual thresholds. A group of individuals was examined, in whom a missing lateral incisor on one side, a peg-shaped or reduced lateral incisor on the other, and a palatal canine were present in the same individual, in order to eliminate gene penetrance and individual thresholds as factors. A distinct preference for the canine anomaly to occur on the side of the peg-shaped or reduced lateral incisor was found. This was considered to provide evidence in support of the existence of non-genetic, environmental factors in the causation of palatal canine displacement.