上颌第一磨牙根管治疗术后5年疗效分析

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (1): 87-90.

上颌第一磨牙根管治疗术后5年疗效分析

张德辉，郑遥，孙海涛

首都医科大学附属北京世纪坛医院口腔科，北京 100038

收稿日期:2015-01-21 修回日期:2015-11-13 出版日期:2016-02-25 发布日期:2016-03-09
通讯作者: 张德辉，E-mail:zhangdh1966@sina.com
作者简介:张德辉(1966-),男，硕士，副主任医师

A retrospective clinical analysis of endodontic treatment of maxillary first molars

ZHANG De-hui, ZHENG Yao, SUN Hai-tao.

Department of Stomatology, Beijing Shijitan Hospital. Beijing 100038, China

Received:2015-01-21 Revised:2015-11-13 Online:2016-02-25 Published:2016-03-09

摘要/Abstract

摘要： 目的： 评价上颌第一磨牙根管治疗疗效及其影响因素。方法： 回顾170颗诊断为牙髓炎、需行根管治疗的上颌第一磨牙,其中牙科手术显微镜下探查根管、Protaper机用镍钛器械根管预备、热牙胶垂直加压充填根管100颗；肉眼探查根管、Protaper机用镍钛器械根管预备、侧压法充填根管70颗。170颗牙术后行冠或桩冠修复。根据治疗前、后临床检查及X线片，综合充填长度和充填密度两方面，对根管充填质量和根管治疗疗效进行评价。采用Reversion 3.0.2软件包对数据进行统计学分析。结果： 热牙胶垂直加压和侧压法充填根管在充填长度方面优良率分别达到93%、91.4%，两者无显著差异；热牙胶垂直加压充填在充填密度方面优良率达到96%，优于冷牙胶侧压法的84.3%，两者差异显著；2种方法的综合根管充填质量优良率分别达到91%、75.7%，差异显著。肉眼近颊第二根管（MB2）发现率为31.4%，根管显微镜下MB2发现率为55%，两者差异显著。热牙胶垂直加压和侧压法充填根管治疗术后5年临床成功率分别达到98%、81.4%，两者差异显著；术后5年热牙胶垂直加压法根管充填无论充填长度还是充填密度均无变化,稳定性好，维持高质量的根管充填，RCT优良率维持在91%；而侧压法根管充填长度无变化，但RCT优良率由75.7%下降为68.6%。术后5年无1例冠折。结论： 上颌第一磨牙根管形态复杂，根管显微镜有助于发现MB2。机用镍钛器械预备根管，热牙胶垂直加压充填上颌第一磨牙，无论充填长度还是充填密度，均可获得良好效果，上颌第一磨牙根管治疗术后应常规行冠或桩冠修复。

关键词: 上颌第一磨牙, 近颊第二根管, 根管治疗, 牙科手术显微镜

Abstract: PURPOSE: To evaluate the effect of root canal therapy (RCT) of maxillary first molars and the relevant influential factors. METHODS： A total of 170 maxillary first molars undergoing endodontic treatment were retrospectively studied. 100 molars were treated with vertical compaction technique (VCT) using warm gutta- percha under dental operating microscope(DOM),while 70 molars with traditional lateral compaction technique(LCT) under naked eyes. All patients were asked to revisit 5 years later and 5- year success rate was evaluated. Reversion 3.0.2 software package was used to analyze the data. RESULTS: The immediate high quality rates of RCT of VCT and LCT were 91% and 75.7%, respectively, which has significant difference (P<0.05). After 5 years, VCT kept high quality rate of RCT, while the high quality rate of RCT with LCT dropped from75.7% to 68.6%. The 5-year clinical success rates of RCT with VCT and LCT were 98% and 81.4%, respectively; which had significant difference (P<0.05). CONCLUSIONS: VCT has excellent clinical effect in RCT of maxillary first molars. The use of DOM can increase the detection rate of the second mesiobuccal canal (MB2).

Key words: Maxillary first molars, Second mesiobuccal canal, Root canal treatment, Dental operating microscope

中图分类号:

R781.05

张德辉，郑遥，孙海涛. 上颌第一磨牙根管治疗术后5年疗效分析[J]. 上海口腔医学, 2016, 25(1): 87-90.

ZHANG De-hui, ZHENG Yao, SUN Hai-tao.. A retrospective clinical analysis of endodontic treatment of maxillary first molars[J]. Shanghai Journal of Stomatology, 2016, 25(1): 87-90.

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