应用根管显微镜处理阻塞根管的疗效评价

目的:评价根管显微镜在阻塞根管处理中的临床价值。方法:应用根管显微镜,配合超声器械处理因钙化、塑化物、折断器械造成的3种根管阻塞患牙113颗,共计161个根管。按照阻塞原因、阻塞牙位以及根管内阻塞部位的不同,比较根管疏通成功率的差别,采用SPSS10.0软件对成功率进行χ2检验。结果:161个阻塞根管疏通131个,总成功率达81.37%。由钙化、塑化物、折断器械造成的根管堵塞,其疏通成功率分别为84.27%、81.58%和73.53%,三者之间差异无统计学意义(P>0.05)。前牙组、前磨牙组和磨牙组疏通成功率分别为93.48%、84.61%和72.37%;磨牙组疏通成功率显著小于前牙组(P<0.01)。直根管及弯曲部位以上根管的疏通成功率为93.98%,弯曲部位以下根管的成功率为21.42%,差异有统计学意义(P<0.01)。结论:在根管显微镜下疏通阻塞根管有较明显的效果,但牙位及阻塞的部位等因素对疏通效果有一定影响。

Evaluation of the use of dental operating microscope in the management of blocked canals

PURPOSE: This study was performed to evaluate the value of dental operating microscope(DOM) in treating blocked canals. METHODS: 161 blocked canals in 113 teeth were treated with ultrasonic instruments under DOM. The etiology of canal blockage included calcification, resinifying therapy and broken instruments. All canals were grouped based on the cause of blockage, teeth site and blockage location in canals, and then the success rates of negotiating ,using SPSS10.0 software package, were analyzed with X(2) test. RESULTS: The results showed that 131 canals were negotiated with a success rate of 81.37%.Blocked canals caused by calcification, resinifying therapy and broken instruments were managed with the success rate of 84.27%, 81.58% and 73.53%, respectively.There were no significant differences in the success rate(P>0.05). Blocked canals of anterior were managed successfully with a success rate of 93.48%,canals of premolar with a success rate of 84.61%,and canals of molar with a success rate of 72.37%. There were significant differences in the success rate between anterior and molar teeth(P<0.01).When the blockage was located in straight canals or above the root canal curvature,canals were negotiated with a success rate of 93.98>.However,the success rate decreased to 21.42> when the blockage located below the root canal curvature,and significant differences were found(P<0.01). CONCLUSIONS: It is an effective way to use dental operating microscope to treat blocked canals, but the therapeutic effects might be affected by sites of the teeth and the blockage location in canals.