{"id":3978,"date":"2021-10-02T00:00:00","date_gmt":"2021-10-01T15:00:00","guid":{"rendered":"https:\/\/fukuoka-endodontics.com\/?p=3978"},"modified":"2021-10-02T00:39:54","modified_gmt":"2021-10-01T15:39:54","slug":"%e6%a0%b9%e5%b0%96%e7%97%85%e5%a4%89%e3%81%af%e3%81%a9%e3%81%93%e3%81%ab%ef%bc%9f%e3%80%9c7-apicoectomy","status":"publish","type":"post","link":"https:\/\/fukuoka-endodontics.com\/?p=3978","title":{"rendered":"\u6839\u5c16\u75c5\u5909\u306f\u3069\u3053\u306b\uff1f\u301c#7 Apicoectomy"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">\u30d0\u30a4\u30c8\u5148\u3067\u306e\u6cbb\u7642\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u60a3\u8005\u3055\u3093\u306f40\u4ee3\u5973\u6027\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u524d\u6b6f\u306b\u6839\u5c16\u75c5\u5909\u304c\u3042\u308a\u3001\u6839\u7ba1\u304c\u77f3\u7070\u5316\u3057\u3066\u3044\u308b\u3068\u3044\u3046\u982d\u304c\u75db\u3044\u75c7\u4f8b\u3060\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u6b6f\u5185\u7642\u6cd5\u5b66\u7684\u8a3a\u65ad\u306f\u4ee5\u4e0b\u306b\u306a\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#6 Cold N\/A, Perc.(-), Palp.(-), BT(-), Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#7 Cold NR\/20, <strong><span class=\"has-inline-color has-vivid-red-color\">Perc.(\uff0b)<\/span><\/strong>, Palp.(-), <strong><span class=\"has-inline-color has-vivid-red-color\">BT(\uff0b)<\/span><\/strong>, Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#8 Cold N\/A, Perc.(-), Palp.(-), BT(-), Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PA\u306f\u4ee5\u4e0b\u306b\u306a\u308b\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"771\" height=\"1024\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/d922cbef579e59bc0b55c9c37ceee2a1-771x1024.jpg\" alt=\"\" class=\"wp-image-3979\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/d922cbef579e59bc0b55c9c37ceee2a1-771x1024.jpg 771w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/d922cbef579e59bc0b55c9c37ceee2a1-226x300.jpg 226w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/d922cbef579e59bc0b55c9c37ceee2a1-768x1020.jpg 768w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/d922cbef579e59bc0b55c9c37ceee2a1.bmp 864w\" sizes=\"auto, (max-width: 771px) 100vw, 771px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"780\" height=\"1024\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/a14fe976642e7f0835ab8aa9291fc720-780x1024.jpg\" alt=\"\" class=\"wp-image-3980\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/a14fe976642e7f0835ab8aa9291fc720-780x1024.jpg 780w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/a14fe976642e7f0835ab8aa9291fc720-228x300.jpg 228w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/a14fe976642e7f0835ab8aa9291fc720-768x1009.jpg 768w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/a14fe976642e7f0835ab8aa9291fc720.bmp 868w\" sizes=\"auto, (max-width: 780px) 100vw, 780px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">\u6b6f\u5185\u7642\u6cd5\u5b66\u7684\u8a3a\u65ad\u306f\u4ee5\u4e0b\u306b\u306a\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#7<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pulp Dx: Pulp Necrosis, Periapical Dx: Symptomatic apical periodontitis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Recommended Tx: Apicoectomy\uff08\u77f3\u7070\u5316\u304c\u9ad8\u5ea6\u306b\u9032\u3093\u3067\u3044\u308b\u305f\u3081\uff09<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">\u3055\u3066\u3042\u306a\u305f\u306f\u3069\u306e\u90e8\u4f4d\u3092\u6cbb\u7642\u3059\u308b\u3060\u308d\u3046\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#8\u304b\uff1f#7\u304b\uff1f#7\u3068#8\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u308c\u306f\u3069\u306e\u3088\u3046\u306b\u6c7a\u3081\u308b\u306e\u304b\uff1f\u3068\u8a00\u3048\u3070\u3001CBCT\u3068\u81e8\u5e8a\u7684\u306a\u60c5\u5831\u304b\u3089\u7dcf\u5408\u7684\u306b\u8003\u3048\u3066\u6c7a\u5b9a\u3055\u308c\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u8fd1\u5e74\u306e\u8ad6\u6587\u306b\u305d\u306e\u91cd\u8981\u6027\u3092\u8b33\u3063\u3066\u3044\u305f\uff1f\u3082\u306e\u304c\u3042\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33901546\/\">Levy 2021  Use of Cone-beam Computed Tomography as a Critical Component in the Diagnosis of an Infected Nasopalatine Duct Cyst Mimicking Chronic Apical Abscess  A Case Report<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u53e3\u8154\u5185\u306e\u72b6\u6cc1\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#6 Cold+\uff08\u8a73\u7d30\u306a\u3057), Perc.(-), Palp.(-), BT(-), Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#7 Cold+\uff08\u8a73\u7d30\u306a\u3057), Perc.(-), Palp.(-), BT(-), Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#8 Cold+\uff08\u8a73\u7d30\u306a\u3057), Perc.(-), Palp.(-), BT(-), Perio probe(WNL), Mobility(WNL)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">PA\u3068\u53e3\u8154\u5185\u5199\u771f\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"553\" height=\"305\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/f259bf07d8629b091c74dfe2d2055540.png\" alt=\"\" class=\"wp-image-3982\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/f259bf07d8629b091c74dfe2d2055540.png 553w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/f259bf07d8629b091c74dfe2d2055540-300x165.png 300w\" sizes=\"auto, (max-width: 553px) 100vw, 553px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"383\" height=\"552\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/18ccaed3eb1be5041f337e4e0843b700.png\" alt=\"\" class=\"wp-image-3983\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/18ccaed3eb1be5041f337e4e0843b700.png 383w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/18ccaed3eb1be5041f337e4e0843b700-208x300.png 208w\" sizes=\"auto, (max-width: 383px) 100vw, 383px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Sinus tract\u304c\u3042\u308b\u306e\u306b\u3001#8\u306fCold(+)\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\uff1f\uff1f\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u306a\u305c\u3060\u308d\u3046\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3042\u306a\u305f\u306e\u691c\u67fb\u306e\u65b9\u6cd5\u304c\u60aa\u304b\u3063\u305f\u306e\u3060\u308d\u3046\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u308c\u3068\u3082\u4ed6\u306b\u554f\u984c\u304c\u3042\u308b\u306e\u3060\u308d\u3046\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u3046\u3044\u3046\u8a3a\u65ad\u306b\u6574\u5408\u6027\u304c\u5f97\u3089\u308c\u306a\u3044\u3068\u304d\u306f\u3001CBCT\u3092\u5229\u7528\u3059\u308b\u3053\u3068\u3092\u4e00\u822c\u7684\u306b\u85a6\u3081\u3089\u308c\u3066\u3044\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CBCT\u3092\u64ae\u5f71\u3057\u305f\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CBCT imaging revealed a low-density area partially surrounded by a high-density (corticated) area, which <strong><span class=\"has-inline-color has-vivid-purple-color\">appeared as a widening of the nasopalatine duct<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"462\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/c1d68b6067eab0aa8bf80a067bad87c6-1024x462.png\" alt=\"\" class=\"wp-image-3984\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/c1d68b6067eab0aa8bf80a067bad87c6-1024x462.png 1024w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/c1d68b6067eab0aa8bf80a067bad87c6-300x135.png 300w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/c1d68b6067eab0aa8bf80a067bad87c6-768x346.png 768w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/09\/c1d68b6067eab0aa8bf80a067bad87c6.png 1049w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span class=\"has-inline-color has-vivid-purple-color\">The lesion<\/span><\/strong>, which was somewhat <strong><span class=\"has-inline-color has-vivid-purple-color\">asymmetrical and irregularly shaped<\/span><\/strong>, <strong><span class=\"has-inline-color has-vivid-purple-color\">perforated the palatal<\/span><\/strong> and, <strong><span class=\"has-inline-color has-vivid-purple-color\">to a much lesser extent, the buccal <\/span>cortical bone plates of the alveolar process<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nasopalatine cyst\u3092\u7591\u3063\u305f\u8457\u8005\u306f\u53e3\u84cb\u304b\u3089\u5916\u79d1\u6cbb\u7642\u3092\u884c\u3044\u3001\u56a2\u80de\u72b6\u7269\u8cea\u3092\u751f\u691c\u306b\u51fa\u3057\u305f\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3059\u308b\u3068\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u7d50\u679c\u304c\u8fd4\u3063\u3066\u304d\u305f\u306e\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The histopathologic findings were an inflamed cyst with an upper respiratory\u2013type and stratified squamous epithelium with adjacent mucous glands. In addition, a large colony of Actinomyces spp. was found surrounded by an inflammatory infiltrate in a typical \u201csunray\u201d appearance, which is consistent with an active Actinomycosis infection. <strong><span class=\"has-inline-color has-vivid-purple-color\">These findings are consistent with the diagnosis of an infected Nasopalatine Duct Cyst<\/span><\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3064\u307e\u308a\u3001Apicoectomy\u3092\u305b\u305a\u306b\u9f3b\u53e3\u84cb\u7ba1\u56a2\u80de\u3068\u7591\u3063\u3066\u53e3\u84cb\u304b\u3089\u30d5\u30e9\u30c3\u30d7\u3092\u958b\u3051\u305f\u305f\u3081\u306b\u4f59\u8a08\u306a\u6cbb\u7642\u3092\u884c\u308f\u306a\u304f\u3066\u6e08\u3093\u3060\u306e\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3064\u307e\u308a\u3001\u8457\u8005\u306fCBCT\u306e\u304a\u9670\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3065\u3051\u3066\u3044\u308b\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><s>\u3057\u304b\u3057\u79c1\u304b\u3089\u8a00\u308f\u305b\u308c\u3070\u3001#8\u306fCold(+)\u306b\u306a\u3063\u305f\u6642\u70b9\u3067\u6839\u7ba1\u6cbb\u7642\u306e\u5bfe\u8c61\u306b\u306f\u306a\u3089\u306a\u3044\u3060\u308d\u3046\u3002<\/s><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><s>\u3082\u3057\u3053\u308c\u3092\u975e\u5916\u79d1\u7684\u306b\u3053\u3068\u3092\u85a6\u3081\u3066\u3044\u304f\u306e\u3067\u3042\u308c\u3070\u2026<\/s><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><span class=\"has-inline-color has-vivid-red-color\">\u751f\u691c\u4ee5\u5916\u306b\u305d\u308c\u3092\u8abf\u67fb\u3059\u308b\u65b9\u6cd5\u306f\u306a\u3044\u3002<\/span><\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u3057\u305f\u304c\u3063\u3066\u304b\u306a\u308a\u8ced\u3051\u306e\u8981\u7d20\u3082\u5f37\u3044\u51e6\u7f6e\u306b\u306a\u3063\u305f\u3068\u8a00\u3048\u308b\u3060\u308d\u3046\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span class=\"has-inline-color has-vivid-purple-color\">\u3067\u3082CBCT\u304c\u3042\u308c\u3070\u9f3b\u53e3\u84cb\u7ba1\u56a2\u80de\u3068\u7591\u3046\u3053\u3068\u304c\u3067\u304d\u308b\u3002<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><span class=\"has-inline-color has-vivid-purple-color\">\u305d\u308c\u304c\u5927\u4e8b\u306a\u306e\u3067\u3042\u308b\u3002<\/span><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u3044\u3046\u3053\u3068\u3067\u8a3a\u65ad\u306b\u306fCBCT\u306f\u6b20\u304b\u305b\u306a\u3044\u3082\u306e\u3067\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u306f\u8ad6\u3092\u5f85\u305f\u306a\u3044\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u305d\u306e\u4ed6\u306e\u81e8\u5e8a\u60c5\u5831\u3068\u3057\u3066\u306f\u3001<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><span class=\"has-inline-color has-vivid-red-color\">NPDC is the most common nonodontogenic cyst in the maxilla and therefore should always be suspected in cases of radiolucency in the maxillary incisor area. <\/span><\/strong><\/h2>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><span class=\"has-inline-color has-vivid-red-color\">The pulp of adjacent teeth will usually stay vital even in large NPDCs.<\/span><\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">\u3053\u306e\u8fba\u308a\u304c\u6c7a\u5b9a\u6253\u306b\u306a\u308b\u306e\u3060\u308d\u3046\u3002<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u3044\u3046\u3053\u3068\u3067\u3001CBCT\u306f\u81e8\u5e8a\u4e0a\u6709\u52b9\u3067\u3042\u308b\u3002<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p class=\"wp-block-paragraph\">\u3067\u3001\u3053\u306e\u75c7\u4f8b\u3067\u3042\u308b\u304c\u3044\u304b\u304c\u3060\u308d\u3046\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">#8\u306e\u53f3\u306b\u5b58\u5728\u3059\u308b\u306e\u306f\u66e9\u80de\u304b\uff1f\u305d\u308c\u3068\u3082\u9f3b\u53e3\u84cb\u7ba1\u304b\uff1f<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u8a00\u3048\u3070\u3001CBCT\u304c\u5f79\u306b\u7acb\u3064\u306e\u3067\u305d\u306e\u60c5\u5831\u3092\u898b\u3066\u307f\u3088\u3046\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"344\" height=\"344\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/bcf49a3de60b45ca8785254668d35bcb.bmp\" alt=\"\" class=\"wp-image-3985\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/bcf49a3de60b45ca8785254668d35bcb.bmp 344w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/bcf49a3de60b45ca8785254668d35bcb-300x300.jpg 300w, https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/bcf49a3de60b45ca8785254668d35bcb-150x150.jpg 150w\" sizes=\"auto, (max-width: 344px) 100vw, 344px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">\u3068\u3044\u3046\u3053\u3068\u3067\u3001#8\u306e\u53f3\u306b\u5b58\u5728\u3059\u308b\u306e\u306f\u9f3b\u53e3\u84cb\u7ba1\u3068\u8003\u3048\u3089\u308c\u308b\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><span class=\"has-inline-color has-vivid-purple-color\">#7\u306f\u77f3\u7070\u5316\u304c\u9ad8\u5ea6\u306b\u9032\u3093\u3067\u3044\u308b\u305f\u3081\u306b\u5916\u79d1\u6cbb\u7642\uff08Apicoectomy\uff09\u3068\u306a\u3063\u305f\u3002<\/span><\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"773\" height=\"1024\" src=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/b5264f31a93e4c9b898922711f8650cb-773x1024.jpg\" alt=\"\" class=\"wp-image-3986\" srcset=\"https:\/\/fukuoka-endodontics.com\/wp-content\/uploads\/2021\/10\/b5264f31a93e4c9b898922711f8650cb-773x1024.jpg 773w, 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