Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
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Root canal therapy of anterior teeth with dens invaginatus

치내치를 동반한 상악 전치의 근관치료

  • Ji-Soo Kim (Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Kkot-Byeol Bae (Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Yun-Chan Hwang (Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Won-Mann Oh (Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Bin-Na Lee (Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 김지수 (전남대학교 치의학전문대학원 치과보존학교실) ;
  • 배꽃별 (전남대학교 치의학전문대학원 치과보존학교실) ;
  • 황윤찬 (전남대학교 치의학전문대학원 치과보존학교실) ;
  • 오원만 (전남대학교 치의학전문대학원 치과보존학교실) ;
  • 이빈나 (전남대학교 치의학전문대학원 치과보존학교실)
  • Received : 2023.11.11
  • Accepted : 2024.02.02
  • Published : 2024.02.29
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Abstract

Dens in dente is a developmental anomaly resulting from infolding of the enamel organ into dental papilla prior to calcification of dental tissue. The pulpal tissue of the tooth can be vulnerable for bacterial invasion through direct exposure to the oral cavity or through defective enamel and dentin of the infolding part, thereby increasing the possibility of pulpal necrosis and subsequent apical periodontitis. Treatment planning of teeth with dens invaginatus may be difficult due to the complex root canal morphology. Therefore, thorough knowledge of anatomical variations of dens invaginatus is of great importance for proper treatment planning. The focus of this case report is on Oehler's type II and III dens invaginatus. The infolding of type III dens invaginatus extends beyond the crown and CEJ. Bacterial invasion through the infolding can easily cause inflammation of the pulpal and periradicular tissue. This case report presents endodontic treatment of type II and III dens invaginatus with the aid of CBCT.

치내치(dens in dente)는 치아 조직이 석회화되기 전에 발생하는 발달 이상이다. 치내치의 치수 조직은 구강에 직접 노출되거나 함입 부위의 법랑질 및 상아질 결함을 통해 노출될 수 있으며, 세균 감염에 취약하다. 이에 따라 치내치는 치수 괴사와 그에 따른 치근단 치주염의 가능성이 높아 진다. 치내치가 있는 치아의 치료는 복잡한 근관 형태로 인해 어려움이 있을 수 있다. 그러므로, 치내치의 해부학적 변이에 대한 세부적인 파악은 적절한 치료계획을 위해 상당히 중요하다. 본 증례보고는 Oehler의 제 2형과 제 3형 치내치(dens invaginatus)에 대해 다룬다. 2형 치내치는 함입이 백악-법랑 경계 하방으로 연장되어 치근 내로 함입되어 있으나, 치주인대와 교통하지 않으며, 3형 치내치는 함입부가 치관에서 백악법랑경계(CEJ)를 넘어 연장된다. 함입부를 통한 세균 침입은 치수 및 치근 주위 조직의 염증을 쉽게 일으킬 수 있다. 본 증례보고는 CBCT를 이용한 제 2형 및 제 3형 치내치의 근관 치료 과정을 보고하고자 한다.

Keywords

Acknowledgement

This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP)(Nos. 2022R1A2C1010249 and 2022R1A4A1029312).

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