School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Morfološke nepravilnosti zuba izazov su svakom specijalistu endodoncije. Kako bi ih se uspješno lociralo i tretiralo, treba biti svjestan svih anatomskih varijacija korijenskih kanala. Svrha ovog prikaza jest opisati nekirurško liječenje prvog lijevoga maksilarnog premolara s geminacijom. Dvadesetogodišnja pacijentica poslana je na endodontski tretman prvog lijevoga maksilarnog premolara. Nakon kliničke i radiološke obrade specijalist endodoncije je dijagnosticirao nekrozu pulpe s kroničnim apikalnim parodontitisom te geminaciju zuba. Korijenski kanali obrađeni su instrumentima ProTaper Universal™. – za bukalni kanal odabran je F3, a za palatalni F4. Nakon toga osušeni su sterilnim papirnatim pointom i napunjeni tehnikom hladne lateralne kondenzacije gutaperkom ProTaper te punilom AH-plus. Na kontrolnom pregledu nakon dvanaest mjeseci zub je bio asimptomatičan i na radiološkoj slici nije se vidjela periapikalna radiolucencija. Treba istaknuti da se čak i kod zuba s iznimno kompleksnom morfologijom korijenskih kanala može postići
adekvatno cijeljenje bez komplikacija, ako se odaberu uobičajene endodontske metode bez kirurških zahvata.Morphological aberrations in teeth present challenges to root-canal treatment. In such cases, an awareness of the possible anatomical variations is essential to localize and successfully treat the entire root-canal system. The purpose of this case report was to describe a nonsurgical treatment of a maxillary left first premolar with gemination. A 20-year-old female patient was referred for endodontic
treatment of her maxillary left first premolar. Based on the clinical and radiographic examination, pulp necrosis and chronic apical periodontitis and a geminated tooth were diagnosed. The root canals were instrumented using the ProTaper Universal™ rotary system up to F3 and F4 instruments, respectively, for the buccal and palatal root canals. The root canals were dried with sterile paper points and filled with ProTaper gutta-percha points and AH Plus Sealer using a cold lateral condensation technique. At the 12-month follow-up, the tooth was asymptomatic and there was no radiolucency around the apical region. Even in a tooth with extremely complex root canal morphology, a conventional endodontic treatment without surgical intervention can result in adequate healing without any complications
