显微根管外科手术失败的原因分析及防治策略  

Causative analysis,prevention and treatment on failure of endodontic microsurgery

作　　者：王捍国 WANG Han-guo(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Department of Operative Dentistry and Endodontics,School of Stomatology,The Fourth Military Medical University,Xi'an 710032,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,第四军医大学口腔医院牙体牙髓病科,陕西西安710032

出　　处：《牙体牙髓牙周病学杂志》2024年第11期621-628,646,共9页Chinese Journal of Conservative Dentistry

基　　金：空军军医大学第三附属医院临床新技术项目(LX2023-310)。

摘　　要：本文以文献为基础,系统回顾笔者15年来显微根管外科失败病例,分析失败原因,根据时间分为近期和远期失败两类。诊断错误、治疗方案不合理和手术操作不规范导致近期失败,而远期失败主要因为继发性根裂、继发其它病变、手术操作不完善和合并严重牙周病变。针对失败原因,提出相应处理方案,即纠正错误、拔除患牙和再次手术。预防策略包括建立正确诊断、选择合适病例、制定合理治疗计划以及进行规范化操作,避免近期失败,降低远期失败发生率,以提高手术成功率,有效治疗牙髓根尖周病,保存健康天然牙。Based on the literature,this paper systematically reviews the failure cases of endodontic microsurgery in the past 15 years.according to the time point:short-term and long-term failuresthe reasons for the failures are analyzed and classified into two categories.Incorrect diagnosis,unreasonable treatment plans,and non-standard surgical procedures lead to short-term failures,while long-term failures are mainly due to secondary vertical root fracture,other diseases,imperfect surgical procedures,and severe periodontal disease.Corresponding treatment plan is proposed,including error correction,extraction,and re-surgery.Prevention strategies include establishing correct diagnosis,selecting appropriate cases,developing reasonable treatment plans,and implementing standardized procedures to avoid short-term failures,reduce long-term failure,to improve the success rate of endodontic microsurgery,effectively treat pulp and periapical diseases,and preserve healthy natural teeth.

关 键 词：显微根管外科 失败 预防 治疗 

分 类 号：R781.3[医药卫生—口腔医学]