歯科用手術顕微鏡とコーンビームCTを用いた上顎側切歯および副鼻腔遠隔管におけるOehlers III型Dens Invaginatusの根管治療．

Root Canal Treatment of Oehlers Type III Dens Invaginatus in Maxillary Lateral Incisor and Remote Sinus Tract Using Dental Surgical Microscope and Cone-Beam Computed Tomography.

抄録

Dens invaginatusとは，歯牙形成時の発育異常により歯冠のエナメル質および象牙質の一部が歯髄腔内に侵入する歯の形態異常である．本報告では、Oehlers III型侵襲性歯周炎が原因と思われる上顎側切歯1例を報告する。患者は69歳の男性で、上顎右側切歯に違和感を訴えて当院を受診した。コーンビームCT（CBCT）により，上顎側切歯にdens invaginatusが認められ，上顎中切歯部には上顎側切歯の根尖性歯周炎に由来する洞道が認められた．侵入洞は複雑な根管形態を伴っていた。歯科用手術顕微鏡を用いた治療は良好な結果をもたらした。患者は術後1年経過した現在も良好な状態を維持している。

Dens invaginatus is a morphological abnormality of the tooth that results from a developmental anomaly during tooth formation, in which part of the enamel and dentin of the crown invaginates into the pulp cavity. This report describes a case of a maxillary lateral incisor with apical periodontitis apparently caused by Oehlers Type III dens invaginatus. The patient was a 69-year-old man who visited our clinic complaining of discomfort in the maxillary right lateral incisor. Cone-beam computed tomography (CBCT) revealed dens invaginatus of the maxillary lateral incisor and a sinus tract in the maxillary central incisor region, which was derived from apical periodontitis of the maxillary lateral incisor. The dens invaginatus was accompanied by a complex root canal morphology. Treatment, which was performed using a dental surgical microscope, had a favorable outcome. The patient remains in good condition at 1 year postoperatively.