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APEKSİFİKASYON TEDAVİSİ BAŞARISIZ OLAN KÖK UCU TAMAMLANMAMIŞ ÜST ORTA KESER DİŞİN PERİAPİKAL CERRAHİ İLE TEDAVİSİ: OLGU SUNUMU

PERIAPICAL SURGICAL TREATMENT OF AN IMMATURE CENTRAL INCISOR FOLLOWING UNSUCCESSFUL APEXIFICATION TREATMENT: A CASE REPORT

Journal Name:

  • İstanbul Üniversitesi Diş Hekimliği Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
This case report presents the periapical surgical treatment of a traumatized immature central incisor with a large periapical lesion following failed apexification treatments. The left central incisor of an 14-year old girl was diagnosed as an immature tooth with a periapical lesion and draining fistula. The tooth was biomechanically cleaned and the slurry calcium hydroxide was introduced to the root canal for apexification treatment. Apexification treatment was maintained for 6 month changing calcium hydroxide every month. The fistula disappeared alter the treatment. The root canal was obturated with mineral trioxide aggregate and the tooth was restored. At the 6-month recall, the tooth was presenting llstula and mild swelling on the mucosa. The periapical lesion was removed surgically and the root end was resected. The lesion was diagnosed as a radicular cyst histopalhologically. At the 6-month recall following the surgery, the tooth was asympthomatic clinically and the new bone formation was seen around the root end radiographically. Periapical surgery is indicated for the treatment of non-vital immature teeth with persistent periapical lesions which do not heal with the apexification techniques.
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Abstract (Original Language): 
Bu olgu sunumunda, travma nedeniyle kök gelişimi durmuş, kök kanalı enfekte olmuş ve periapical lezyon gelişmiş üst sol santra] dişin, başarısız olan apeksifıkasyon tedavisinden sonra periapikal cerrahi tekniği ile tedavisi anlatılmaktadır. 14 yaşındaki kadın hastanın, üst sol santral dişi incelendiğinde, kök ucunun henüz kapanmamış olduğu ayrıca periapikal lezyon ve akmakta olan bir fislül ağzının varlığı saptandı. Üst santral dişin apeksilikasyonu için biyomekanik temizleme sonrasında '6 ay boyunca aylık seanslarda, kök kanalları kalsiyum hidroksit ve steril tuzlu su karışımı ile dolduruldu. Klinik olarak fislülüıı kapanması sonucunda, kök kanalı MTA ile dolduruldu ve diş restore edildi. 6 ay sonraki takip seansında, klinik olarak tislülün yeniden oluştuğu ve radyogralik olarak periapikal lezyonun varlığını sürdürdüğü görüldü. Periapikal cerrahi sırasında kök ucu rezeke edildi ve lezyon kürete edilerek çıkartıldı. Hıslopatolojik olarak le/yona radiküler kist tanısı koyuldu. Hastanın 6 ay sonraki kontrolünde dişin klinik olarak sağlıklı olduğu ve radyolojik olarak lezyonun iyileştiği gözlendi. Bu olgu bildirisi, apeksifıkasyon tedavisinde, uzun süreli kalsiyum hidroksit uygulaması ve MTA ile kanal doldurma gibi başarısının çok yüksek olduğu bilinen tekniklerin hile ba/en başarısızlıkla sonuçlanabileceğini ortaya koymaktadır. Böyle inatçı ve iyileşmeyen apeksifıkasyon olgularında periapikal cerrahi uygulanarak iyileşmenin sağlanabileceği bu olguda gösterilmektedir.
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