亚甲兰染色在显微根尖手术中的应用观察  

Observation on the aPPlication of methylene stain in microtiP surgery

作　　者：陆乐 陈珠佳 Lu Le;Chen Zhu-jia(DePartment of dental PulP,affiliated oral hosPital,Suzhou University,Jiangsu Suzhou 215000,China)

机构地区：[1]苏州大学附属口腔医院牙体牙髓科,江苏苏州215000

出　　处：《全科口腔医学电子杂志》2018年第23期3-4,共2页Electronic Journal of General Stomatology

摘　　要：目的观察亚甲蓝染色运用于显微根尖手术治疗慢性根尖周炎的疗效。方法选取慢性根尖周炎既往根管治疗失败的患者20例进行在显微根尖手术,手术流程包括翻瓣去骨、根尖切除、亚甲蓝染色根尖切除断面、根管倒预备、MTA倒充填、术区缝合及定期复诊观察。结果 20例病例中,在术中通过亚甲蓝染色观察,发现根管微裂1例,遗漏根管6例,根管穿孔1例,管间峡区8例,根充不密合1例,其他3例。应用亚甲蓝染色能够在显微根尖手术中观察根切面,评估根切是否完整,分析原先根管治疗失败的原因,辅助完成根尖手术。除1例根折患牙拔除,其余19例患牙在治疗后复诊期间无不适症状,原有瘘管消失,牙龈恢复正常,12个月后复查X线片显示根尖部MTA封闭严密,原有根尖周阴影缩小甚至消失。结论亚甲蓝染色在显微根尖手术治疗中的评估更为方便和准确,从而提高根尖手术的成功率。Objective To evaluate the outcome of endodontic microsurgery by methylene blue staining in the treatment of Persistent aPical Periodontitis.Methods 20 Patients with refractory aPical Periodontitis as study subjects received endodontic microsurgery.Surgical Procedures included raising mucoPeriosteal flaP,ostectomy,PeriaPical curettage,root-end resection,methylene blue staining,retroPreParation with ultrasonic microtiPs,and root-end filling with mineral trioxide aggregate（MTA）.The effect was monitored clinically and radiograPhically.Results Among the 20 cases,by methylene blue staining,we observed1 case with root canal microfissure,6 cases with missing root canal,1 case of root canal Perforation,8cases of interstitial canal,1 case of no root filling and 3 other cases.After staining with the methylene blue,the root surface can be observed in the root aPical surgery to assess the integrity of the root cut,analyze the failure of the original root canal treatment and assist the root aPex surgery.ExcePt for 1 case of root fractures,the remaining 19 Patients had no symPtoms during the follow-uP.The original fistula disaPPeared and the gums returned to normal.After 12 months,the X-rays showed that the aPical MTA was tightly closed and the shadow of the aPical Period shrunk or even disaPPeared.Conclusion The method with Methylene blue staining is more convenient and accurate in the evaluation of the endodontic microsurgery,so as to imProve the success rate of aPical surgery.

关 键 词：亚甲蓝染色 瘘管消失 牙龈 

分 类 号：R782.1[医药卫生—口腔医学]