A Retrospective Study on the Treatment of Dens Evaginatus for the Last 5 Years

J. Lim, G. Kim, Jaesik Lee, Soonhyeun Nam, Hyunjung Kim
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Abstract

The purpose of this study was to analyze treatment methods, results, timings and clinical signs and symptoms in failed cases of each treatment method of dens evaginatus on the premolar areas. In this study, 151 patients and 417 teeth were included. Resin restoration and direct pulp capping as preventive treatment and pulp revascularization, apexification and conventional endodontic treatment as endodontic treatment were included for treatment methods. In the preventive resin restoration, successful results were shown in the intact tubercles and also effective when the tubercles were fractured. In the direct pulp capping, resolved clinical symptoms and growth of the roots were shown when there was only pain during chewing without apical lesion. Apical lesion was the most common pretreatment signs and symptoms of the pulp revascularization, apexification and conventional endodontic treatment. In the pulp revascularization, successful results was obtained in most cases. But in some cases, root length or root wall thickness was not increased. Effective results were shown both of the apexification and conventional endodontic treatment. In order to increase success rate of preventive treatment of dens evaginatus, resin restoration was required to be done when tubercle did not occluded or in the presence of intact tubercles. When tubercle was fractured, root development stage and pulp condition should be considered for successful treatment.
近5年来外翻牙槽治疗的回顾性研究
本研究的目的是分析各种治疗方法在前磨牙区外翻牙的治疗方法、效果、时机及失败病例的临床体征和症状。本研究共纳入151例患者和417颗牙齿。预防方法包括树脂修复和直接盖髓,治疗方法包括牙髓血运重建、根尖化和常规牙髓治疗。在预防性树脂修复中,在完整的结节中显示出成功的结果,在结节断裂时也有效。直接盖髓时,临床症状得到缓解,牙根生长良好,咀嚼时只有疼痛,根尖无损伤。根尖病变是牙髓血运重建术、根尖固定术和常规根管治疗最常见的预处理症状和体征。在牙髓血运重建术中,大多数病例都取得了成功。但在某些情况下,根长或根壁厚度没有增加。根尖治疗与常规根管治疗均有较好的效果。为了提高外翻牙的预防治疗成功率,在未闭塞或存在完整结节的情况下,需要进行树脂修复。当结节骨折时,应考虑根发育阶段和牙髓状况,以确保治疗成功。
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