下顎側切歯にみられた歯内歯に対する保存的歯内療法処置

  • 小林 健二
    明海大学歯学部機能保存回復学講座歯内療法学分野
  • 小谷 依子
    明海大学歯学部機能保存回復学講座歯内療法学分野
  • 高橋 哲哉
    明海大学歯学部機能保存回復学講座歯内療法学分野
  • 呉 崇史
    明海大学歯学部機能保存回復学講座歯内療法学分野
  • 片山 直
    明海大学歯学部機能保存回復学講座保存修復学分野

書誌事項

タイトル別名
  • Conservative Endodontic Treatment for Dens in Dento which Appeared in Mandibular Lateral Incisor

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抄録

Dens in dente, or dens invaginatus, is a developmental anomaly of the hard tissues of teeth. Endodontic treatment of a dens in dente in which the invagination communicates with the periodontal ligament is very difficuls. Therefore, most clinicians recommend extraction. Here, we present a case of successful conservative endodontic therapy by apexification of an immature permanent tooth with dens in dente. An 11-year-old girl was referred for endodontic treatment of a right mandibular lateral incisor with dens in dente. Radiographic observation revealed that the invagination communicated with the periodontal ligament (Type III, according to Oehlers' classification). Computed tomography (CT) was used to further examine the anatomical form of the root canal. The imaging information from CT was helpful for endodontic treatment. Two root canals including a main root canal, and the invaginated root canal of the incomplete root were observed. Pulpectomy was performed in the main root canal, and apexification was attempted after the invaginated root canal was treated endodontically. An apical hard tissue barrier was formed 14 months after treatment, after which the root canal was obturated by gutta-percha. At the 1-year recall examination, the tooth remained asymptomatic and reduction of the lesion was evident in the radiograph.

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