动静态导航技术在牙髓根尖周病治疗中的应用及展望  

Application and prospect of static/dynamic guided endodontics for managing pulpal and periapical diseases

作　　者：杜宇[1] 韦曦[1] 凌均棨[1] Du Yu;Wei Xi;Ling Junqi(Department of Operative Dentistry and Endodontics,Guanghua School of Stomatology,Hospital of Stomatology,Sun Yat-sen University&Guangdong Provincial Key Laboratory of Stomatology,Guangzhou 510055,China)

机构地区：[1]中山大学光华口腔医学院·附属口腔医院牙体牙髓病科·广东省口腔医学重点实验室,广州510055

出　　处：《中华口腔医学杂志》2022年第1期23-30,共8页Chinese Journal of Stomatology

基　　金：广东省财政高水平医院建设专项资金(174-2018-XMZC-0001-03-0125/A-01);广东省自然科学基金(2021A1515010845)。

摘　　要：根管治疗及根尖手术是处理牙髓根尖周病的常规方法。相比裸眼操作,口腔手术显微镜的普及和应用有效提高了治疗精准度及预后。然而,在面临严重根管钙化、根尖周病损定位困难或毗邻重要解剖结构等复杂情况时,即使经验丰富的术者在进行显微牙髓治疗的过程中也存在风险因素。近年来,随着数字化信息技术的快速发展,动静态导航技术为应对疑难复杂牙髓根尖周病提供了行之有效的治疗新模式,即通过锥形束CT拍摄、口内扫描、结合导航软件设计手术虚拟入路,继而在三维打印导板或实时导航设备的辅助下进行精准根管治疗或根尖手术。本文对导航牙髓治疗的分类、特点以及国内外临床应用现状进行了系统阐述。Root canal therapy and endodontic surgery are conventional treatments for pulpal and periapical diseases.Compared with naked-eye operations,the application of dental operating microscope has enhanced the procedural accuracy and prognosis efficiently.However,root canals with pulp calcification/obliteration,apical lesions with thick cortical bone or adjacent to important anatomic structures are even challenging for experienced operators to achieve predictable clinical outcomes.Recently,with the advances in the field of digitalized information sciences,the above mentioned complicated endodontic cases can be solved under static and dynamic guidance.Before the treatment begins,virtual path is designed from data collected by cone-beam CT and oral image scanning using guidance software.Afterwards,root canal therapy and endodontic surgery can be performed precisely under the assistance of three-dimensional printed guide or dynamic guidance system.The present review describes the classification,features and clinical applications of the guided endodontics.

关 键 词：根管疗法 锥束计算机体层摄影术 静态导航牙髓治疗 动态导航牙髓治疗 显微根尖手术 

分 类 号：R781.34[医药卫生—口腔医学]