根管手术显微镜下上颌第二前磨牙的根管再治疗  

Endodontic Retreatment of Maxillary Second Premolars Using a Dental Operating Microscope.

作　　者：金艳 邹韵秋 郑雨燕 马丽辉 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院口腔科,广东深圳518020

出　　处：《口腔医学研究》2008年第6期673-675,共3页Journal of Oral Science Research

基　　金：2008年深圳市科技计划项目(医疗卫生类)(编号:200803084)

摘　　要：目的:探讨运用根管手术显微镜和现代根管治疗技术对上颌第二前磨牙进行根管再治疗的疗效。方法:选择临床上需行根管再治疗的上颌第二前磨牙63颗,利用根管手术显微镜去除初次治疗的失败因素,小号K锉疏通根管,镍钛机用根管锉冠向下法预备主根管,显微镜下使用超声与K锉预备峡区,1%NaClO超声冲洗根管系统,热牙胶垂直加压充填根管。记录初次治疗失败原因,根管再次探查和疏通的效果、再治疗根充效果及半年随访效果。结果:63颗上颌第二前磨牙初次治疗失败的主要原因为根管预备不充分和根管充填不完善。再治疗三维适填达86%。半年随访成功率达85%。结论:峡区、根尖分叉和根尖弯曲是上颌第二前磨牙根管治疗失败的主要解剖原因。显微根管再治疗可以获得理想的疗效,值得临床推广使用。Objective： To evaluate the effectiveness of clinical retreatment of maxillary second premolars using contemporary endodontic technique and dental operating microscope （DOM）. Methods： 63 maxillary second premolars which need endodontic retreament were selected. The operative errors of treated endodontic cases were corrected by using DOM and ultrasonic technique. Teeth were explored by a small size K file. The main canals were instrumented by Ni - Ti instruments while the isthmus were instrumented by ultrasonic and K files under the DOM. All cases were irrigated by 1% NaC10 and ultrasonic, obturated by vertical compaction technique. The agents of failure in primary treatment, the explored effect, the obturation result and effectiveness of retreatment were recorded. Results ： The two greatest causes of failure in the primary treament revealed： inadeguate cleaning and shaping and incomplete obturation. 86% cases were complete obturated in the retreatment and 85 % cases were testified successful six month later. Conclusion： Isthmus,apical furcation and curvature are anatomic failure causes of primary endodontic treatment. The endodontic treatment with the use of DOM can make the therapy more successful.

关 键 词：根管手术显微镜 上颌第二前磨牙 根管再治疗 峡区 

分 类 号：R781.05[医药卫生—口腔医学]