中华口腔医学研究杂志(电子版) ›› 2011, Vol. 5 ›› Issue (01) : 52 -57. doi: 10.3877/cma.j.issn.1674-1366.2011.01.008 × 扫一扫
临床研究
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Qiong XU1, Jian-wei LIU1, Jun-qi LING1,†()
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徐琼, 刘建伟, 凌均棨. 手术显微镜配合超声技术处理钙化根管的临床疗效[J/OL]. 中华口腔医学研究杂志(电子版), 2011, 5(01): 52-57.
Qiong XU, Jian-wei LIU, Jun-qi LING. Clinical effect of calcified root canals with ultrasonic instruments under dental operating microscope[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2011, 5(01): 52-57.
目的
探讨牙科手术显微镜配合超声技术处理钙化根管的临床疗效和应用方法。
方法
选择需进行根管治疗的40 例患者的患牙43 颗（47 个钙化根管），在手术显微镜下采用超声工作尖和（或）超声根管锉去除根管内钙化组织，结合乙二胺四乙酸（EDTA）、小号手用锉疏通根管，机用镍钛器械ProTaper 完成根管预备，侧向加压或垂直加压技术充填根管。 记录钙化根管疏通成功率及根管内并发症的发生情况。
结果
47 个钙化根管中有37 个根管疏通成功并完成根管治疗，钙化根管再通成功率为78.7%；前牙疏通成功率89.5%，后牙疏通成功率71.4%；根管口及上段再通成功率为87.9%，下段再通成功率为57.1%。 1 颗磨牙根管中段形成台阶，2 个根管发生侧穿，6 根超声器械断裂，无牙根折裂发生。
结论
手术显微镜配合超声技术是处理钙化根管的有效方法，前牙及根管口及上段再通成功率较高，该技术不宜用于根管的下段及弯曲部位。
Objective
This research aimed to study the clinical effect of calcified root canals with ultrasonic instruments under dental operating microscope.
Methods
Forty seven calcified root canals of 43 teeth from 40 patients were negotiated with ultrasonic instruments under operating microscope， combined with EDTA and small size hand files， then shaped by ProTaper Nickel-titanium rotary instruments and filled with lateral or vertical condensation technique. The success rate and complications were recorded.
Results
Thirty seven calcified root canals were negotiated， enlarged and obturated， with a success rate of 78.7%. The success rate of anterior teeth and coronal portion of canal is higher than that of posterior teeth and apical portion of canal.Ten canals failed to be negotiated， two perforations occurred in a curved canal and the canal of a mandibular incisor. Six ultrasonic instruments were fractured and abandoned during the treatment.No vertical fracture was found.
Conclusiosns
The usage of ultrasonic instruments with dental operating microscope is proved to be effective in management of calcified root canals. Nevertheless，the use of the instruments in apical or curved portion of root canals is not encouraged.