手术显微镜联合超声技术在塑化根管再治疗中的应用评价

目的:评价手术显微镜联合超声技术在塑化根管再治疗中的应用。方法:选取曾进行过塑化治疗的患牙63颗,在手术显微镜下,采用超声根管锉疏通塑化根管的上段,小号手用K锉配合EDTA溶液逐步疏通根管下段,机动镍钛器械Hero642完成根管预备,侧向加压充填法充填根管,观察并评价疗效。结果:54颗患牙的根管疏通成功,并完成根管治疗,根管再通成功率为85.7%。治疗过程中无牙根折裂、台阶形成、根管壁侧穿或器械折断发生。结论:手术显微镜和超声器械去除根管内塑化物快速高效,可作为临床上处理塑化再治疗患牙的有效方法,但不推荐将超声器械用于根管的下段或弯曲部位。

Root canal therapy of resinified teeth with surgical operating microscope and ultrasonic instruments

PURPOSE: To evaluate the role of surgical operating microscope and ultrasonic instruments in endodontic treatment of patients who underwent previous resinifying therapy. METHODS: 63 premolars and molars that had been treated with resinifying therapy before were selected for root canal therapy. The coronal portion of resinified root canals were negotiated with ultrasonic instruments under surgical operating microscope, and the apical portion was managed with small size hand files and 15% EDTA. The root canals of all cases were shaped by Nickel-Titanium rotary instruments Hero 642, and obturated with lateral condensation technique. The negotiation of root canal system, instrument fracture, alterations of canal morphology, and operation time were recorded. The efficiency of preparation and obturation was analyzed by radiographs before and after treatment. RESULTS: The root canals of 54 teeth were negotiated, enlarged and obturated, with a success rate of 85.7%. No complications were found, such as vertical fracture, ledge, perforation and instrument separation. Good result of treatment was achieved in the 54 cases. CONCLUSIONS: The use of surgical operating microscope and ultrasonic instruments is proved to be effective in negotiation of coronal portion of the resinified root canals. Nevertheless, the use of ultrasonic instruments in apical or curved portion of root canals is not encouraged. Supported by 2004 Key Clinical Project of the Ministry of Public Health of China.