根尖大面积病变手术治疗的临床疗效观察  

Clinical evaluation of large periapical lesions following apical surgery

作　　者：王霄[1] 黎远皋[1] 潘向勇[1] 

机构地区：[1]北京大学第三医院口腔科,北京100191

出　　处：《华西口腔医学杂志》2010年第6期641-645,共5页West China Journal of Stomatology

摘　　要：目的评估根尖手术治疗大面积根尖病变患牙的疗效。方法选择存在大面积根尖病变的59例患者（59处根尖病变,91颗患牙）为研究对象,根尖病变范围6~21 mm,在根管治疗后进行根尖手术。术后1、3、6、9、12、24个月复诊,对患牙及根尖病变进行临床及影像学评估,综合二者结果进行疗效评估,并对可能影响其术后疗效的各种因素进行统计学分析。结果 59例患者中52例（88.1%）被评估为成功,6例（10.2%）被评估为失败,1例（1.7%）被评估为有效。老年组患者的成功率（63.6%）明显比青年组（87.5%）和中青年组（95.0%）低,具有统计学差异（P=0.037,P=0.017）;磨牙的成功率（75.0%）比前牙（92.6%）和前磨牙（90.0%）均低,具有统计学差异（P=0.041,P=0.047）;性别、根尖病变侵及牙齿数量、根尖病变范围等因素对成功率的影响未见统计学差异（P〉0.05）。结论对于存在大面积根尖病变的患牙,根管治疗后配合根尖手术治疗是一项可选择的治疗方式。Objective To evaluate the therapeutic effect of teeth with large periapical lesions followed apical surgery.Methods 59 patients（59 periapical lesions,91 teeth） with large periapical lesions ranging in size from 6 mm to 21 mm in diameter were included in this study.All teeth were treated by root canal therapy and apical surgery,and the surgical procedure was completed with microsurgical technology and ultrasonic root-end preparation.The outcomes were evaluated clinically and radiographically at 1,3,6,9,12 and 24-month intervals,and the various factors which may affect the success rate were analyzed statistically.Results 52 cases（88.1%） of 59 patients were considered success,6 cases（10.2%） were considered failure,and 1 case（1.7%） was considered in progress.The success rate of elderly patients group（63.6%） was significantly lower than that of the youth group（87.5%） and middle-aged group（95.0%）（P=0.037;P=0.017）.The success rate of molar group（75.0%） was significantly lower than that of the anterior group（92.6%） and the premolar group（90.0%）（P=0.041,P=0.047）;however,there was no significant difference in the gender,the number of teeth invaded in lesions,the size of periapical lesion（P0.05）.Conclusion It is an effective therapy for the teeth with large periapical lesions by apical surgery after root canal treatment.

关 键 词：根尖手术 大面积根尖病变 根管治疗 

分 类 号：R781.05[医药卫生—口腔医学]