著明な過剰根管充填の経過を長期観察した3症例  [in Japanese] Long-term Observation of Marked Overfilling in Root Canal Therapy : A Report of Three Cases  [in Japanese]

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Author(s)

    • 廣島 佑香 HIROSHIMA Yuka
    • 徳島大学大学院ヘルスバイオサイエンス研究部再生修復医歯学部門顎口腔病態制御学講座歯周歯内治療学分野 Department of Periodontology and Endodontology, Oral and Maxillofacial Dentistry, Division of Medico-Dental Dynamics and Reconstruction, Institute of Health Biosciences, The University of Tokushima Graduate School
    • 稲垣 裕司 INAGAKI Yuji
    • 徳島大学大学院ヘルスバイオサイエンス研究部再生修復医歯学部門顎口腔病態制御学講座歯周歯内治療学分野 Department of Periodontology and Endodontology, Oral and Maxillofacial Dentistry, Division of Medico-Dental Dynamics and Reconstruction, Institute of Health Biosciences, The University of Tokushima Graduate School
    • 板東 美香 BANDO Mika
    • 徳島大学大学院ヘルスバイオサイエンス研究部再生修復医歯学部門顎口腔病態制御学講座歯周歯内治療学分野 Department of Periodontology and Endodontology, Oral and Maxillofacial Dentistry, Division of Medico-Dental Dynamics and Reconstruction, Institute of Health Biosciences, The University of Tokushima Graduate School
    • 木戸 淳一 KIDO Jun-ichi
    • 徳島大学大学院ヘルスバイオサイエンス研究部再生修復医歯学部門顎口腔病態制御学講座歯周歯内治療学分野 Department of Periodontology and Endodontology, Oral and Maxillofacial Dentistry, Division of Medico-Dental Dynamics and Reconstruction, Institute of Health Biosciences, The University of Tokushima Graduate School
    • 永田 俊彦 NAGATA Toshihiko
    • 徳島大学大学院ヘルスバイオサイエンス研究部再生修復医歯学部門顎口腔病態制御学講座歯周歯内治療学分野 Department of Periodontology and Endodontology, Oral and Maxillofacial Dentistry, Division of Medico-Dental Dynamics and Reconstruction, Institute of Health Biosciences, The University of Tokushima Graduate School

Abstract

歯内治療において,ときどき過剰根管充填(過剰根充)に遭遇する.一般に,過剰根充は作業長の測定ミスや根充操作時のガッタパーチャポイントの根尖孔外への突き出しが主な原因であるといわれている.根尖孔から2mm以内のわずかな過剰根充であれば根尖歯周組織に為害性はないが,それ以上の著しい過剰根充の場合は,術後の症状やX線写真によるチェックを行い注意深く対応する必要がある.本報告では,X線写真上で2.5〜3.5mmのポイントの突出が認められた3症例(症例1:上顎第二大臼歯,3.0mm,症例2:下顎第一大臼歯,2.5mm,症例3:下顎第一小臼歯,3.5mm)について,最長6〜14年の経過観察を行った結果を提示した.症例1では,突出ポイントは1年5カ月後に切断され3年8カ月後に消失し,6年8カ月後に根尖透過像も改善した.症例2では,突出ポイントは3年後に縮小傾向を示し,14年7カ月後には消失しており,根尖透過像の消失,歯槽硬線の明瞭化が観察された.症例3では,突出ポイントは13年6カ月後にわずかな部分を残して,ほとんどが吸収しており,同時に根尖透過像も消失していた.臨床症状は,症例1で打診痛が長期残存したほかには特記事項はほとんど認められなかった.当該歯は現在も健常に機能している.今回の症例は,術前診断,術中術後の情報を詳細に提示しながら過剰根充されたガッタパーチャポイントの経過と根尖病巣の治癒経過を長期間追跡したものであり,過剰根充の転帰を知るうえで興味深い臨床報告である.

In endodontic therapy, overfilling of gutta-percha point in root canals sometimes occurs due to wrong measurement of working length and overextension of gutta-percha point. Although a slight overfilling to periapical tissues (within 2 mm past the apical foramen) is tolerable, marked overfilling should be checked by postoperative recheck radiographs and/or clinical symptoms. In this report, three clinical cases of marked overfilling are described and long-term radiographic observation (6-14 years) was continued. Overfilled gutta-percha points on the radiographic observation were 3.0 (case 1), 2.5 (case 2), and 3.5 mm (case 3) in the left maxillary molar of a 47-year-old woman, in the left mandibular molar of a 45-year-old woman, and in the left mandibular premolar of a 39-year-old woman, respectively. In case 1, an overfilled point was cut after 1.5 years and disappeared after 3.5 years, and then apical radiolucency was improved after 6 years. In case 2, overfilled points started to minimize after 3 years and disappeared after 14 years. In case 3, an overfilled point was minimized after 13 years accompanied with improvement of apical lesion. None of the cases showed any significant clinical symptoms after the overfilling. These observations are interesting to longitudinally evaluate the disappearance of overfilled gutta-percha and the improvement of apical lesion.

Journal

  • The Japanese Journal of Conservative Dentistry

    The Japanese Journal of Conservative Dentistry 51(5), 485-492, 2008

    The Japanese Society of Conservative Dentistry

References:  19

Codes

  • NII Article ID (NAID)
    110007151262
  • NII NACSIS-CAT ID (NCID)
    AN00191201
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0387-2343
  • Data Source
    CJP  NII-ELS  J-STAGE 
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