应用根管显微镜和超声器械处理阻塞根管的效果评价

目的 评价根管显微镜(dental operating microscope，DOM)和超声器械处理阻塞根管的临床疗效。方法 因钙化、器械折断、根管桩、塑化物或台阶造成的根管阻塞患牙92颗、共135个根管，在根管显微镜下使用专用超声器械进行根管治疗或再处理，统计成功率。结果 77颗患牙(114个根管)完成根管治疗，成功率83．7％，根管再通率84．4％，其中钙化根管的成功率是88．1％，器械折断的根管成功率76．9％，塑化根管的成功率81．1％，台阶根管的成功率78．6％。无一例发生根管侧穿或牙根折裂。结论 根管显微镜和超声器械的使用，为处理阻塞根管提供了行之有效的方法。

Evaluation of the use of dental operating microscope and ultrasonic instruments in the management of blocked canals

Objective To evaluate the use of dental operating microscope (DOM) and ultrasonic instruments in treating blocked canals. Methods 135 blocked canals in 92 teeth were treated with ultrasonic tips and files under DOM. The etiology of canal blockage included calcification, broken instruments, post, resinifying therapy or ledge. These canals were negotiated and root canal therapy or retreatment was performed. The success rates were calculated. Results 77 teeth were successfully managed with a success rate of 83.7%. 84.4% of the blocked canals were negotiated. The success rates of each category of the blocked canals were: 88.1% for calcified canals; 76.9% for canals blocked by instrument fragments; 100% for canals blocked by post; 81.1% for canals subjected to resinifying therapy;and 78.6% for ledged canals. Complications such as root canal perforation or vertical fracture did not occur. Conclusion The use of DOM and ultrasonic instruments is proved to be an effective way in the management of blocked canals.