根管显微镜下上颌第二磨牙根管的再治疗

目的：总结应用根管显微镜和超声器械对上颌第二磨牙根管再治疗的临床疗效。方法：收集上颌第二磨牙初次治疗失败病例80例,显微镜下记录初次治疗失败原因,应用根管显微镜和超声技术疏通根管,机用镍钛锉冠向下法预备根管,侧方加压和垂直加压法充填根管,拍X线牙片记录再治疗成功率。结果：80个患牙再治疗成功71个,成功率88.7%。半年后随访,成功率88.2%。结论：上颌第二磨牙因其根管存在融合、变异、根管过弯等因素,易导致初次治疗时根管遗漏、台阶形成、器械折断、根管侧穿以及根管钙化,造成初次根管治疗失败。应用根管显微镜和超声技术对其进行再治疗能获得满意的疗效,但应正确使用超声器械,避免根管侧穿的发生。

The retreatment of maxillary second molar root canals under endodontic microscope

Objective：To investigate the effect of the retreatment of maxillary second molar root canals using endodontic microscope and ultrasound equipment.Method：Choose 80 maxillary second molar cases with initial treatment failure,use endodontic microscope and ultrasound technique during canal negotiation,use crown-down technique with NickelTitanium file during preparation of root canal system,use lateral and vertical compaction techniques during root canal obturation,record the success rate of retreatment by taking X-ray films.Result：Among 80 cases with retreatment,there are 71 successful root canal obturation cases,which success rate is 88.7 %.Success rate of six months follow-up is 88.2 %.Conclusion：Because there are factors of fusion,variation and excessive curve in maxillary second molar root canals,it is easily to cause initial treatment failure by canals unfinding,ledge forming,instrument fracturing,root canal-side wearing and calcification.Satisfactory results can be obtained by using endodontic microscope and ultrasound technique in retreatment.But we should use ultrasound equipment correctly to avoid root canal-side wearing.