显微超声技术结合CBCT治疗前磨牙复杂变异根管的效果观察  

Efect observation of microscopic ultrasonic technique combined with CBCT in treatment of complex root canals of premolars

作　　者：景双林[1] 黄丽娟[2] 于金华[1] JING Shuanglin;HUANG Lijuan;YU Jinhua

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院牙体牙髓科,江苏南京210029 [2]南京大学医学院附属口腔医院,南京市口腔医院修复科,江苏南京210008

出　　处：《口腔医学》2018年第12期1092-1095,共4页Stomatology

基　　金：国家自然科学基金(81873707)

摘　　要：目的探讨CBCT及显微超声技术在前磨牙变异根管治疗中的联合应用及临床疗效。方法选取20例因根管变异行显微根管治疗的前磨牙,术前行CBCT扫描,分析影像结果,准确获取变异根管的数量、形态、钙化程度等信息,在牙科手术显微镜下使用超声器械定位并疏通根管,机动镍钛系统完成根管预备,热牙胶垂直加压充填。记录变异根管类型及治疗中并发症等情况,评价显微根管治疗的效果。结果 20例患牙中,有19例成功找到所有根管并顺利完成了根管治疗,术中未出现台阶、侧穿、器械分离等并发症,成功率为95%。20例变异根管的分类,以Ⅴ型(1-2型)最为多见,其次为Ⅲ型(1-2-1型)。结论应用显微超声技术可以提高前磨牙变异根管的治疗成功率,CBCT对额外根管的术前检出及术中定位有重要指导作用。Objective To evaluate the combined application of CBCT and microscopic ultrasonic technique in management of complicated root canal therapy of premolars and their clinical efficacy. Methods 20 premolars with aberrant canals which could not be successfully managed by conventional methods were selected. CBCT scan was conducted before the operation and the image results were analyzed. Then the exact number, morphology and calcification of the root canals were obtained. Under the dental operating microscope, ultrasonic instruments were used to locate and probe the root canal. The root canals were shaped using Ni-Ti rotary instrumentation and obturated with warm vertical compaction technique. The types of the variant root canal configuration and complications during treatment were recorded. The curative effect was evaluated. Results 19 teeth among 20 were successfully managed with a rate of 95%. There was no ledge, perforation and instrument separation in all cases. The type of multiple canals in 20 premolars was mainly Type V (Type 1-2), followed by type Ⅲ(type 1-2-1). Conclusions The use of CBCT and dental operating microscope can greatly facilitate successful endodontic therapy in aberrant root canal system of premolars. CBCT plays an important role in guiding the preoperative detection and intraoperative position of the additional root canals.

关 键 词：CBCT 牙科手术显微镜 超声技术 变异根管 

分 类 号：R781.05[医药卫生—口腔医学]