难治性根管50例原因分析及治疗

目的 探讨造成难治性根管常见原因及治疗经验.方法 对2000-2011年经多次完成根管治疗但根尖周炎症反复出现或患牙不适症状无好转而转来就诊的50例患者的临床资料进行回顾性分析.结果 50例患者中发现根管遗漏32例,侧穿4例,残髓炎4例,根充不致密3例,根折2例,误诊5例.除因误诊转科治疗2例外,其余均成功进行针对性治疗,经半年以上时间观察,临床症状消失.结论 难治性根管治疗只是一个相对性的概念,根管遗漏、根管侧穿、残髓炎、根充不完善、根折、误诊等是造成根管治疗难治的常见原因.避免上述原因将有利于根管治疗成功率的进一步提高.

Treatment and reason analysis of 50 cases of refractory root canal

Objective To explore the therapeutic experience and common cause of refractory root canal. Methods Retrospective analysis was conducted on clinical data of 50 patients who transferred to the hospital during 2000 to 2011 with repeated periapical inflammation or without improvement in symptoms of teeth. Results Among the 50 cases, there were 32 cases of root canal omitted, 4 cases of lateral penetration, 4 eases of residual pulpal inflammation, 3 cases of non-dense canal filling, 2 cases of pulp breaking and 5 cases of misdiagnosis. Except two cases transferred to other department for treatment because of misdiagnosis ,the other patients were all with targeted treatment successfully and the clinical symptoms vanished after more than six-month observation. Conclusion The refractory root canal therapy is just a relative concept. Root canal omitting,lateral penetration, residual pulpitis, non-dense canal filling, pulp breaking and misdiagnosis are the common causes for the refractory root canal therapy. To avoid the causes above will further promote the success rate in pulp canal therapy.