病例报告

锥形束CT诊断罕见双生上颌第二前磨牙1例报道

  • 董建辉 ,
  • 朱亚琴
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  • 上海交通大学 医学院附属第九人民医院口腔综合科, 上海 200011
董建辉(1962—), 男, 副主任医师; 电子信箱: jianhui0529@hotmail.com。

网络出版日期: 2015-04-29

Diagnosis of geminated maxillary second premolar by CBCT: a case report

  • DONG Jian-hui ,
  • ZHU Ya-qin
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  • Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Online published: 2015-04-29

摘要

目的 探讨锥形束CT(CBCT)在双生牙诊断中的应用价值。方法 采用CBCT作为辅助方法诊断1例罕见的双生上颌第二前磨牙。对患牙的临床检查及X线片、CBCT检查资料进行回顾性分析,并结合文献复习展开讨论。结果 临床检查发现:患者牙列发育完整,右侧上颌第二前磨牙表现为2个完全分离的牙冠共用1个融合的牙根。X线片显示:右侧上颌第二前磨牙不完全分裂,没有根尖病灶;患牙确切的解剖结构显示不清。上颌骨CBCT图像显示:患牙的2个牙冠在牙釉质牙骨质结合处融合形成1个单一的牙根,2个完全分离的髓腔则在牙釉质牙骨质结合处融合形成1个根管。结论 双生牙是罕见的牙齿发育异常,其结构复杂,往往很难诊断和治疗。利用CBCT的高端成像模式可以帮助临床医师作出正确的诊断并确定治疗方案,从而防止或减少可能出现的并发症。

本文引用格式

董建辉 , 朱亚琴 . 锥形束CT诊断罕见双生上颌第二前磨牙1例报道[J]. 上海交通大学学报(医学版), 2015 , 35(4) : 622 . DOI: 11.3969/j.issn.1674-8115.2015.04.032

Abstract

Objective To investigate the application value of cone beam computed tomography (CBCT) for the diagnosis of twin teeth. Methods CBCT was adopted as an auxiliary method for diagnosing 1 rare case of twin maxillary second premolar. Data of the clinical examination, X-ray, and CBCT examination were retrospectively analyzed and discussed according to literature reviews. Results Clinical examination revealed that the patient had a complete dentition and the right maxillary second premolar was two completely separated crowns sharing one fused root. X-ray findings showed that right maxillary second premolar was incompletely split and no periapical lesion was found. The exact anatomic structure of the tooth was not shown clearly. CBCT images showed that two crowns joined to form 1 single root at the enamel cementum junction of the teeth and 2 completely separated dental pulp chambers fused to form 1 root at the enamel cementum junction. Conclusion Germination is a rare developmental dental anomaly. It is difficult to diagnose and treat due to complicated structures. The high-end diagnostic imaging modalities of CBCT can assist clinicians to make the correct diagnosis and determine the treatment plan, so as to prevent or reduce potential complications.
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