根管治疗失败原因之临床探讨

目的 探讨根管治疗失败的原因.方法 选取200名患者,分析根管治疗失败患牙210颗,根据初次治疗情况、临床检查、术前 X线片以及术中对患牙根管系统的探查等判断原治疗失败的原因.结果 失败病例中慢性根尖周炎患牙最多,占 67.1%,其次是无根尖暗影、但因欠充要求再治疗的患牙,以及存在冠渗漏的患牙;X线片显示 83.8%的患牙欠充,多数后牙根管锥度欠佳;遗漏根管多见于上颌第一磨牙和前磨牙;17.9%的患牙存在台阶、根管偏移等并发症.结论 因预备和充填不当等造成的根管清理不彻底、封闭不严密使根管系统再感染是根管治疗失败的主要原因,遗漏根管、冠部渗漏等也可造成治疗失败.

Clinical Study on the Cause of Failure in Root Canal Therapy

Objective To discuss the cause of failure in root canal therapy. Methods 210 teeth of 200 patients with root canal therapy failure were selected and the causes of failures were analyzed based on the primary treatment,clinical examinations,X-ray films before therapy and the exploration of the root canals. Result Most failures occurred in the teeth with chronic periapical periodontitis,taking up 67.1%,and then in the teeth with no apical radiolucent shadows but insufficient obturation,and as well as in the te...