【作者】 高德； 张月云； 徐保东； 牛晓阳； 周百铭；

【Author】 Gao De;Zhang Yueyun;Xu Baodong;Niu Xiaoyang;Zhou Baiming;Jining Hospital of Stomatology;

【机构】 济宁口腔医院；

【摘要】 目的:改良显微根尖手术并评价三氧化矿物聚合物(MTA)根管倒充填的临床疗效。方法:对58例(65颗牙)常规根管治疗无法治愈的病例进行显微根尖手术治疗,在牙科手术显微镜下借助显微外科器械对患牙进行根尖刮治、根尖切除、根尖倒预备和MTA倒充填,本研究中在根尖切除时采用光纤手机。使用慢机及橡皮杯结合MTA反复摩擦根尖切除后的牙根断面。术后3、6、12个月复诊通过临床和X线片检查评价术后1年的疗效,分为成功和失败病例。结果:58例65颗患牙1年后成功63颗患牙,成功率为97.0%,其中完全愈合的病例为87.7%,好转病例为9.3%,1例患牙因根折拔除,1例患牙根尖病变未缩小。结论:显微根尖手术具有极佳的临床疗效,对显微根尖外科手术的改良使得操作更加简便易行。更多还原

【Abstract】 Objective:The purpose of this study was to improve endodontic micro-surgery and to evaluate the outcome of clinical treatment by retrograde root filling with MTA.Methods:58 cases(a total of65 teeth) with failed conventional root canal treatment were included for endodontic microsurgery.Surgical treatment included periapical curettage,root-end resection,retropreparation with ultrasonic microtips,and root-end filling with MTA.All surgical procedures were performed under dental operating microscopes with microsurgical instruments.In this study fiber optic hand-piece was used for apical resection and root section was frictioned repeatedly with slow handpiece,rubber cup and MTA.Healing was monitored clinically and radiogra-mmphically using well defined criteria for three months,six months,one year.Cases were classified into success and failure cases according to the outcome evaluation.Results:97.0%of the surgically treated cases showed successful healing after one year.Among them,87.7%of the cases were completely healed and9.3%of the cases were improved.One case was removed because of root fracture while apical lesion of one case was not reduced.Conclusion:The outcome of the present study indicates that endodontic surgery with the use of dental operating microscope and microsurgical instruments result in excellent treatment outcome.Improvement of endodontic surgery makes the operation more simple.更多还原