Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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Regenerative Endodontic Treatment Without Discoloration of Infected Immature Permanent Teeth Using Retro MTA : Two Case Reports

치수 괴사된 미성숙 영구치에서 Retro MTA를 이용한 변색 없는 재생적 근관치료 : 증례 보고

  • Kim, Yujeong (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Kim, Seonmi (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University) ;
  • Choi, Namki (Department of Pediatric Dentistry, School of Dentistry, Chonnam National University)
  • 김유정 (전남대학교 치과대학 소아치과학교실) ;
  • 김선미 (전남대학교 치과대학 소아치과학교실) ;
  • 최남기 (전남대학교 치과대학 소아치과학교실)
  • Received : 2014.06.19
  • Accepted : 2014.10.08
  • Published : 2014.11.30
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Abstract

Regenerative endodontic treatment has the potential to heal a necrotic pulp, which can affect root development in immature teeth. However, several drawbacks and unfavorable outcomes are associated with regenerative endodontic treatment, of which the most significant is coronal discoloration due to the presence of minocycline in triple antibiotic paste and mineral trioxide aggregate (MTA). To prevent tooth discoloration following pulp treatment, the modified triple antibiotics (ciprofloxacin, metronidazole, clindamycin) were used as canal disinfectants and Retro MTA, a $ZrO_2$-containing calcium aluminate cement, was used to seal the canal. Following access cavity acquisition, the canal was copiously irrigated with 2.5% sodium hypochlorite. A modified triple antibiotic paste was then applied to the canal. Once the tooth was asymptomatic (after between 3 and 8 weeks), Retro MTA was carefully placed over the blood clot or a collagen plug. Follow-up radiographs revealed normal periodontal ligament space and root development. In two cases, successful regenerative endodontic treatment of the infected immature tooth, without discoloration, was achieved with disinfection using modified triple antibiotics and Retro MTA sealing.

재생적 근관치료는 치수 괴사를 보이는 미성숙 영구치 치료에 있어서 괴사된 치수를 치유하고 계속되는 치근의 발달을 유도할 수 있다. 그러나 여기에는 몇 가지 단점과 불리한 결과들이 있다. 이 중 재생적 근관치료에 가장 큰 임상적 부작용은 minocycline과 MTA에 의한 변색이다. 본 증례에서는 재생적 근관치료 후에 나타나는 치관 변색을 방지하기 위해 minocycline을 clindamycin으로 대체한 triple antibiotics와 칼슘 지르코늄 알루민산염 시멘트인 Retro MTA를 사용하였다. 치수 괴사된 미성숙 영구치에서 근관 와동 형성 및 근관 세척 후 수정된 triple antibiotics를 적용하고, 혈병 또는 콜라겐 스펀지를 스캐폴드(scaffold)로 하여 Retro MTA로 근관을 폐쇄하였다. 정기적인 검진 결과 미성숙 영구치의 치근 성장 및 정상적인 치아 주위 조직들이 관찰되었으며, 치관 변색 없이 모두 양호한 치유 결과를 얻었다.

Keywords

References

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