上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (10): 1409-.doi: 10.3969/j.issn.1674-8115.2011.10.011

• 论著（临床研究） • 上一篇    下一篇

显微超声技术结合热牙胶充填进行根管再治疗效果分析

黄轶锋1, 洪 瑾1, 杜 嵘2, 朱丽娜1   

  1. 上海交通大学 医学院附属第九人民医院 1.口腔特需门诊, 2.口腔综合科 上海市口腔医学重点实验室, 上海 200011
  • 出版日期:2011-10-28 发布日期:2011-10-27
  • 通讯作者: 洪 瑾, 电子信箱: hongjin1221@yahoo.cn。
  • 作者简介:黄轶锋（1971—）, 男, 副主任医师, 硕士；电子信箱: jeff_huang108@yahoo.com.cn。
  • 基金资助:

    上海市科委生物医药重大（点）科技攻关项目（064119542）

Clinical evaluation of root canal retreatment with micro-ultrasonic technique and warm vertical technique

HUANG Yi-feng1, HONG Jin1, DU Rong2, ZHU Li-na1   

  1. 1.Stomatology Special Consultation Clinic, 2.Department of General Dentistry, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Online:2011-10-28 Published:2011-10-27
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 064119542

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摘要：

目的 分析根管治疗失败的原因，探讨显微超声技术在根管再治疗中的效果及提高再治疗成功率的有效方法。方法 选取首次根管治疗失败病例63例（82颗患牙），分析治疗失败的原因；应用显微根管超声技术清理、扩大根管，热牙胶充填系统进行充填根管。于治疗后3、6、12、24个月时复查，统计根管再治疗成功率。结合文献复习、总结影响根管再治疗效果的因素。结果 首次根管治疗失败的主要原因为医源性因素（欠充、不密合及根管遗漏、根管内有折断器械等），占67.07%。根管再治疗后为期2年的临床随访结果显示：82颗患牙中，治疗成功48颗，进步23颗，失败11颗，再治疗成功率为86.59％；再治疗失败的11颗患牙中，因牙折或牙根纵裂拔除3颗，另8颗在X线片上显示根管充填情况良好但根尖阴影增大或又出现黏膜肿胀和窦道。结论 医源性因素是根管治疗失败的主要原因。合理、完善的治疗操作结合显微超声技术和热牙胶充填可有效提高根管再治疗的成功率。

关键词: 根管再治疗, 根管显微镜, 超声技术, 热牙胶充填

Abstract:

Objective To analyse the causes of failure in root canal treatment, evaluate the clinical effect of micro-ultrasonic technique on root canal retreatment, and explore the method to improve the success rate of retreatment. Methods A total of 63 patients (82 teeth) who failed in first root canal treatment were selected, and the causes of failure were analysed. Micro-ultrasonic technique was used to clean and expand the root canal, and warm vertical technique was employed to fill the root canal. Patients were reexamined 3, 6, 12 and 24 months after treatment, and the success rate of root canal retreatment was calculated. The influencing factors for clinical effect of root canal retreatment were explored with literature review. Results Iatrogenic factors (underfilling, loose filling, root canal missing and broken instrument in root canal) contributed to most (67.07%) of the failure in first root canal retreatment. After 2 years of follow up, the success rate of retreatment was 86.59%, including cure in 48 teeth, improvement in 23 teeth and failure in 11 teeth. Among the 11 teeth with failure in retreatment, 3 were extracted due to tooth fracture or vertical root fracture, and the other 8 exhibited fine root canal filling and enlarged apical shadow on X-ray images or had mucosa swelling and sinus. Conclusion Iatrogenic factors are the major causes for failure in root canal treatment. The success rate of root canal retreatment can be increased by proper management with micro-ultrasonic technique and warm vertical technique.

Key words: root canal retreatment, dental operating microscope, ultrasonic technique, warm vertical obturation