根管显微镜下三氧化物多聚体封闭根端的疗效观察

目的：评价根管显微镜下三氧化物聚合体（mineral trioxide aggregate,MTA）封闭恒牙根尖孔开放形成根尖屏障的疗效。方法：选择恒牙根尖孔开放合并根尖周炎的患牙63颗,在根管显微镜下用三氧化物多聚体（MTA）严密封闭根端,形成根尖屏障后以热牙胶充填,定期复诊观察。结果：63颗患牙中,1颗（23）因牙根长及舌向倾斜,在显微镜下视野不清导致欠填,其余62颗患牙均充填严密。术后X线片显示43颗适充,17颗少量超充。3个月后复查,2例因瘘管反复不闭合行手术倒充填,2例失访,其余患牙均达到成功要求,无叩痛,复查X线片示根尖周病变明显缩小或消失,骨小梁再现。少量超填不影响疗效,总成功率为95%。结论：牙科手术显微镜下MTA封闭治疗根尖孔开放的恒牙疗效确切,准确方便。

Treatment of teeth with open canal system using mineral trioxide aggregate as apical barrier under the dental operating microscope

PURPOSE: To evaluate the effect of closing root apex of permanent teeth with mineral trioxide aggregate to form barricade in root tip under the dental operating microscope. METHODS: 63 teeth treated in our department with open root apex and periapical periodontitis were selected, MTA was used to rigorously close the root apex under microscope, and thermoplastic gutta pertscha was used to fill dental root after formation of barricade in the root tip. All patients revisited regularly for clinical examinations after treatment. RESULTS: Among the 63 treated teeth, only one tooth (23) was insufficiently filled because of the long dental root and unclear field of vision under microscope, the remaining 62 teeth were filled adequately. The postoperative dental film showed 43 teeth were properly filled while 17 had a little over-filling. The patients were rechecked after three months, and the results showed that 2 patients underwent retro-filling because of fistula, 2 patients were lost during follow-up period, and the remaining patients reached the requirement for success including no sensitivity to percussion, improvement or disappearance of pathological changes around the root tip on dental film and regeneration of bone trabecula. The therapeutic effect was not influenced by minor over-filling. The overall success rate was 95%. CONCLUSION: The method of using mineral trioxide aggregate (MTA) to treat teeth with root apex open is accurate and convenient and the effect is pretty good.