根尖倒充填术与根尖刮治术的临床疗效观察

目的 运用根尖倒充填术治疗常规根管治疗无法治愈的病例,并与根尖刮治术对比,观察临床疗效并评价其临床应用价值.方法选取通过常规根管治疗术无法处理或疗效不佳的根尖周炎患牙62颗,将其分为刮治组和倒充填组两组,每组31颗,在显微镜下分别进行根尖刮治术和根尖倒充填术,根据术后X线片判断即刻倒充填效果,术后1年、2年复查,根据患者感受、临床检查和X线片结果进行疗效评价.结果共有49颗患牙进行了疗效观察.刮治组1年及2年成功率分别为52%(12/23)、45%(9/20);倒充填组1年及2年成功率分别为85%(22/26)、88%(22/25).倒充填组1年和2年成功率均高于刮治组(1年成功率比较x2=6.0,P<0. 05;2年成功率比较x2=9.6,P<0.005).结论对根管治疗术无法处理或疗效不佳的患牙采用根尖倒充填术可获得良好的疗效.

Clinical evaluation of periapical endodontic surgery for endodontic failure

Objective To evaluate the clinical outcome of periapical endodontic surgery for teeth that can't be treated by nonsurgical endodontic methods. Methods Sixty-two affected teeth were chosen for surgical endodontic treatment, of which 31 teeth underwent periapical curettage and the others were treated by root-end resection, retrograde preparation and filling. A radiography was taken immediately after surgery and was compared with those taken at 12 and 24 months. The results of two groups were analyzed using the X2 test. Results The success rate for retrograde filling was higher (85% after 12 months, 88% after 24 months) compared with that of periapical curettage (52% after 12 months, 45% after 24 months). The difference in success rate between the two groups was statistically significant. Conclusions Ultrasonic root-end preparation and retrograde filling is a good choice of treatment when the teeth can't be treated appropriately by nonsurgical treatment.