摘要
目的用根管显微技术对根管治疗失败的下颌前磨牙进行再处理。方法收集下颌前磨牙可疑因根管变异导致根管治疗失败的病例38例共41颗牙,其中下颌第一前磨牙19颗。利用根管显微镜对每颗患牙进行根管变异的诊断,并在镜下对各根管进行镍钛机动预备、热牙胶垂直加压充填。根管治疗术后定期复查2年。结果初次治疗时诊断为单根管的35颗患牙,在根管显微镜下无一例为单根管,28颗为双根管,7颗为三根管;初次治疗时诊断为双根管的6颗患牙,有2颗为双根管,4颗为三根管,即41颗再处理患牙有30颗(73.17%)为双根管,有11颗为三根管(26.83%),根管遗漏率达95.12%(39/41)。除一例再处理的患牙在寻找根管的过程中出现侧穿需要MTA修补外,其余患牙均能进行根管定位和完成根管治疗。经复查无一例患牙出现治疗失败。结论根管显微技术能提高对变异根管的识别率,为提高根管再处理成功率提供保障。
Objective： To diagnose and treat the mandibular premolar teeth with root canal varieties using operative microscope. Methods ：38 cases with 41 mandibular premolars, including 19 first premolar, were examined and treated by dental operative microscope because of previous root canal therapy（RCT） failure diagnosed by clinical and radiographic examinations. In the following RCT operative microscope was applied in the process of examination of canal varieties, canal preparation by motor rotated Ni-Ti, and canal obturation with warm vertically condensed gutta-percha technique. The patients were followed up for two years. Results：35 teeth with previously diagnosed with single canal in each tooth were proved to be with two canals in 28 cases and three in 7. Six teeth with previously diagnosed with two canals were proved to be with two in 2 cases and three in 4 cases. Among the 41 teeth, 30 were with two canals （73.17%） and 11 with three（26.83% ）. The rate of missing canal by clinical and radiographic examination was 95.12% （39/41）. MTA repair was used in one tooth because of perforation, all other teeth were finished successfully by RCT. None of the treated teeth showed periapical deterioration in the 2-year follow-up. Conclusion：The dental operative microscope is a valuable tool in endodontic diagnosis and treatment.
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2006年第2期155-158,共4页
Journal of Practical Stomatology
基金
2004年卫生部临床学科重点项目
关键词
根管显微镜
下颌前磨牙
解剖形态变异
根管再处理
Dental operative microscope
Mandibular premolar
Anatomical aberration
Retreatment
