306颗牙周-牙髓联合病变的治疗观察

目的 探讨治疗牙周-牙髓联合病变的有效方法 。方法 对306颗牙周-牙髓联合病变患牙采用牙周病-牙髓病联合治疗的方式进行治疗;行洁治术、刮治术,牙周袋内放入碘甘油甲硝唑棒、盐酸米诺环素软膏进行牙周给药,及牙体牙髓治疗。结果 牙周-牙髓联合病变患牙306颗,经2年随访,痊愈207颗,好转90,失败9颗。总有效率达90.8%。结论 对牙周-牙髓联合病变患牙进行牙周牙髓联合治疗,效果良好。?     

对牙周-牙髓联合病变分型的思考

结合现行高等学校教材《牙周病学》中牙周- 牙髓联合病变的叙述和临床、教学工作中存在的问题,阐述对牙周- 牙髓联合病变分型的理解,提出牙周- 牙髓联合病变不再分型的思考。     

牙周牙髓联合病变患牙预后观察的回顾性研究

目的:观察牙周源性牙周-牙髓联合病变患牙的预后效果.方法:回顾性分析南京大学医学院附属口腔医院牙周病科2013～2015年同一医师治疗完成的74颗牙周-牙髓联合病变患牙临床资料,按牙齿存留与否分为A、B两组,根据年龄、性别、随访次数、基线及治疗后5年时牙周临床检查指数等分析影响预后的可能因素,采用Kap-lan-Mei...     

牙周牙髓联合病变患牙显微根尖手术一例

牙周牙髓联合病变（endodontic-periodontal lesions）是指同一个牙并存着牙周和牙髓病变,且互相融合连通。显微根尖手术是实现疑难牙髓根尖周病患牙保存的重要手段。牙周牙髓联合病变患牙根尖手术远期预后较牙周健康患牙差,牙周炎症控制与组织再生是影响其远期成功率的关键因素。对于牙周牙髓联合病变患牙,临床医生需要根据病因和骨缺损类型,选择正确的手术时机与方式,尽可能提高患牙手术成功率。     

GTR联合根尖手术治疗牙周牙髓联合病变伴重度牙槽骨缺损上颌磨牙1例

牙周牙髓联合病变涉及牙髓和牙周组织,其诊疗难度较大,预后一般不佳。本文报道1例牙周源性的牙周牙髓联合病变伴重度牙槽骨缺损的上颌第一磨牙,经根管治疗术、牙周基础治疗、引导性组织再生术(guided tissue regeneration, GTR)和同期根尖手术联合治疗,达到意向性保留患牙的目的。     

107例牙周-牙髓联合病变患牙的临床治疗体会

目的：观察牙周-牙髓联合病变患牙的联合治疗效果。方法：对107例牙周-牙髓联合病变的139个牙的临床资料进行分析,采取牙周牙髓联合治疗,观察临床疗效。结果：经过1年的随访,联合治疗总有效率82.73%,其中根尖周病变引起的牙周病变治疗效果好,且前牙好于后牙。结论：临床上对牙周-牙髓联合病变患牙及时采用系统的综合治疗可以最大限度保存患牙,取得良好的临床疗效。     

根管治疗对牙周源性牙周牙髓联合病变细菌谱的影响

目的:分析牙周源性牙周牙髓联合病变根管治疗前、后牙周微生物的差异,探讨根管治疗对牙周牙髓联合病变预后的影响.方法:收集2018～2020年新疆维吾尔自治区人民医院接诊的牙周源性牙周牙髓联合病变并发逆行性牙髓炎的患牙31例,采集根管治疗前、后牙周袋和根管治疗前根管内标本,提取DNA采用荧光定量PCR对福赛斯坦纳菌、牙龈卟...     

牙周牙髓联合病变动物模型的建立

目的建立一种实验性牙周牙髓联合病变的动物模型,为研究牙周牙髓联合病变的发病机制及探讨治疗模式奠定基础。方法选用30只250~300 g SD大鼠,以3-0丝线结扎大鼠左侧上颌第一磨牙的牙颈部以造成牙周炎,并在咬合面开髓以造成牙髓炎,配合饲以软食和高糖水,分别于0、1、2、4、8周观察动物造模后临床表现、X线及组织病理学的变化。结果4周,造模大鼠在临床、X线及组织病理方面均有明显、典型的牙周牙髓联合病变表现。结论以本法建立的牙周牙髓联合病变动物模型,能模拟临床牙周牙髓联合病变的自然发生过程,用于牙周牙髓联合病变的进一步研究。     

牙髓源性牙周牙髓联合病变6年疗效观察1例

本文报告1例牙髓源性牙周牙髓联合病变,通过反复多次根管冲洗和封药,未经牙周基础治疗最终控制感染,观察期6年,预后良好.     

碘仿糊剂根管充填加碘仿纱条局部填塞综合治疗牙周-牙髓联合病变临床评价

牙周病和牙髓病彼此可相互影响,出现错综复杂的临床表现,称之为牙周-牙髓联合病变.它是有着不同来源、不同预后的一组疾病,多发于40 岁以上的中老年人,且随着年龄的增加发病呈上升趋势,临床表现比较复杂,疗程较长,预后较差.笔者自1999-09～2006-05通过对230 颗中老年牙周-牙髓联合病变患牙进行碘仿糊剂根管充填加碘仿纱条局部填塞的综合治疗,取得了令人满意的临床效果,结果报道如下.     

The endo-perio problem in dental practice: diagnosis and prognosis

The relationships between endodontics and periodontics are explored. Diagnosis, prognosis, and treatment planning are discussed for the primary endodontic lesion and the primary endodontic lesion with secondary periodontal involvement. These endodontic lesions are compared with primary periodontal lesions and primary periodontal lesions with secondary endodontic participation. The "true" combined lesion is also reviewed. Clinical photographs and radiographs are used to illustrate specific aspects.     

牙周牙髓病损预后的临床分析

目的 通过临床病例回顾分析牙周牙髓病损原发病因的诊断，治疗方案的选择对患牙预后的重要性。方法 选择31颗牙周牙髓病损患牙，临床详细检查，根据患牙的分类选择相应牙周，牙髓治疗方法，6－24个月评价临床愈合。结果 源于牙髓感染的牙周病损，牙周治疗需要量小，预后最好；源于牙周感染的牙髓病损，患牙预后取决于牙周病变程度，牙髓治疗未显著提高骨缺损的修复。评估牙周牙髓联合病变的预后，需监测阶段性治疗效果，牙周治疗需要量大。结论 牙周牙髓病损的临床需详细分析原发病因，选择优化治疗方案，监测阶段性治疗效果。     

Conventional and Surgical Retreatment of Complex Periradicular Lesions With Periodontal Involvement

A periradicular pathosis with an associated periodontal breakdown creates a complex problem during endodontic therapy. In cases in which nonsurgical retreatment does not have a successful outcome, a surgical retreatment has to be taken into consideration. With the introduction of microsurgical techniques in endodontics, surgical treatment success has improved considerably. The surgical treatment of combined lesions, however, is still considered to have a less favorable prognosis. The presented cases illustrate successful treatments in which a periodontal breakdown and an endodontic breakdown were present.     

Endodontic, surgical and periodontal treatment of dens invaginatus. Case report

The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.     

Hemisection for treatment of an advanced endodontic-periodontal lesion: a case report

AIM: To emphasize the importance of primary endodontic treatment when dealing with endo-perio lesions and to demonstrate the considerable healing potential of the endodontic aspect. CASE REPORT: After several years of unsuccessful symptomatic periodontal treatment, an advanced endo-perio lesion on a right-mandibular first molar was successfully treated by root-canal treatment and hemisection after the re-evaluation of the lesion. This successful treatment appeared to have a positive effect on the patient's general well-being. KEY LEARNING POINTS: The origin of a combined endo-perio lesion is indicated by its clinical and radiographic appearance. The periodontal situation is often misinterpreted. The prognosis for the endodontic element of treatment is excellent. Local pathologic processes in the oral cavity may affect a patient's general health.     

Interaction between endodontics and periodontics

Endodontic–periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. Etiologic factors, such as bacteria and viruses, as well as contributing factors, such as trauma, root resorptions, perforations, cracks and dental malformations, play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic–periodontal lesions vary, depending on the etiology, pathogenesis and correct diagnosis of each specific condition. This chapter will appraise the interrelationship between endodontic and periodontal lesions and provide biological and clinical evidence for diagnosis, prognosis and decision‐making in the treatment of these conditions.     

大锥度镍钛器械与“危险区”牙周牙髓联合损害

目前被广泛使用的大锥度镍钛器械提高了根管预备的工作效率,并能得到较好的成形和清理效果。但因其在根管冠方的牙本质去除量较大,有可能在下颌第一恒磨牙近中根"危险区"这一特殊解剖部位造成牙周损伤,从而引发牙周牙髓联合病变。本文就大锥度镍钛器械根管预备,与下颌第一恒磨牙"危险区"Ⅰ型牙周牙髓联合病变的关系做一综述。     

The endo‐perio lesion: a critical appraisal of the disease condition

Endodontic–periodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions. Treatment and prognosis of endodontic–periodontal diseases vary and depend on the cause and the correct diagnosis of each specific condition. This article will appraise the interrelationship between endodontic and periodontal diseases and provide biological and clinical evidence of significance for diagnosis, prognosis, and decision‐making in the treatment of these conditions.     

Step‐wise treatment of two periodontal‐endodontic lesions in a heavy smoker

Aim To report a clinical case of two advanced periodontal‐endodontic lesions with a focus on treatment issues related to tobacco use. Summary A 53‐year‐old Caucasian male was referred to the School of Dentistry, Basel, Switzerland, for periodontal treatment. The major diagnoses were chronic (smoker) periodontitis and advanced combined periodontal‐endodontic lesions on the mandibular left lateral incisor and right incisor. Conventional root canal treatment was performed, and subsequently led to reduced radiolucencies around the affected roots after 14 months. The remaining osseous defect was augmented by guided tissue regeneration using bovine bone substitute and resorbable membrane. The follow‐up revealed a stable situation from clinical (probing depth 2–4 mm) and radiological points of view 32 months after initiation of treatment. Treatment considerations related to tobacco use are discussed. Key learning points ? After conventional root canal treatment, osseous healing should occur before further complementary therapy is taken into account. ? Issues related to tobacco use have to be considered before treatment is initiated.     

Treatment Strategy for Guided Tissue Regeneration in Combined Endodontic-Periodontal Lesions: Case Report and Review

IntroductionEndodontic-periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult.MethodsTwenty-six cases from 14 articles involving the successful management of endodontic-periodontal lesions with concurrent regenerative procedures were reviewed. This article also presents successful treatment of an endodontic-periodontal combined lesion involving a grade II mesial furcation of a maxillary molar with root canal treatment and multiple regenerative procedures.ResultsA treatment algorithm is outlined for the application of the guided tissue regeneration (GTR) in managing endodontic-periodontal combined lesion. This treatment algorithm consists of 4 phases: (1) presurgical phase (determining periodontal/regenerative prognosis), (2) endodontic phase, (3) periodontal surgical phase, and (4) post-GTR reevaluation protocol.ConclusionsThe proposed 4-phase treatment algorithm might provide a beneficial guideline in managing the endodontic-periodontal combined lesions.