下颌第一磨牙牙髓塑化治疗后根管再治疗的研究  

Study of root canal retreatment of resinified mandibular first molar

作　　者：张志刚[1] 徐爱凤[1] 侯本祥[1] 

机构地区：[1]首都医科大学附属北京口腔医院牙体牙髓科,北京100050

出　　处：《现代口腔医学杂志》2011年第4期245-248,共4页Journal of Modern Stomatology

摘　　要：目的探讨牙髓塑化治疗失败病例再治疗的方法,分析再治疗的临床效果。方法选取牙髓塑化治疗后需行根管再治疗的下颌第一磨牙212例,记录患者一般情况和X线片的表现,随机分成四组,每组53例,在显微镜辅助下,分别采用单纯手用扩大针,超声器械配合手用扩大针,镍钛器械配合手用扩大针,超声、镍钛器械和手用扩大针联合应用取根管内塑化物并尝试扩通根管,记录根管扩通情况。结果在所有曾做过牙髓塑化治疗的下颌第一磨牙中,单纯手用扩大针组有5例患牙扩通全部塑化根管,占9.43%;超声器械配合手用扩大针组有12例患牙扩通全部塑化根管,占22.64%;镍钛器械配合手用扩大针组有28例患牙扩通全部塑化根管,占52.83%;超声、镍钛器械和手用扩大针联合应用组有39例患牙扩通全部塑化根管,占73.58%。存在慢性根尖周炎的患牙有65例,占30.66%。结论在显微镜辅助下,超声器械、镍钛器械、手动器械联合应用是去除根管内塑化物并扩通根管的最有效方法。Objective To investigate suitable method of retreating resinified mandibular first molar and to assess the clinical effect of the retreatment.Methods A total of 212 mandibular first molars,which need root canal retreatment after resinifying,were divided into four groups,with 53 in each.The general condition and X-ray results were recorded.With the aid of microscope,hand reamer,hand reamer with ultrasonic instruments,hand reamer with nickel titanium instruments,and hand reamer with ultrasonic,nickel titanium instruments were used to withdraw root canal plastic material and to extend through the root canal.Meanwhile,the dilation condition was recorded.Results Using hand reamer,9.43% of the resinified teeth could achieve the work length;using hand reamer with ultrasonic instruments,22.64% achieved the desired result;using hand reamer with nickel titanium instruments,52.83% achieved the result;using hand reamer with ultrasonic and nickel titanium instruments,73.58% achieved the result.Conclusion The combined method of hand reamer with ultrasonic and nickel titanium instruments can achieve the best result of dilating the resinified root canal.

关 键 词：牙髓塑化治疗 根管再治疗 牙髓治疗 慢性根尖周炎 

分 类 号：R781.05[医药卫生—口腔医学]