显微根尖手术探查根管治疗失败的可能原因分析

上海口腔医学 ›› 2015, Vol. 24 ›› Issue (2): 206-209.

显微根尖手术探查根管治疗失败的可能原因分析

钱文昊¹,洪瑾²,徐培成¹

1.上海市徐汇区牙病防治所,上海 200032;
2.上海交通大学医学院附属第九人民医院·口腔医学院口腔特需科,上海 200011

收稿日期:2014-06-18 出版日期:2015-04-20 发布日期:2015-07-24
通讯作者: 徐培成,E-mail:xpc1238@126.com
作者简介:钱文昊（1974-）,男,硕士,副主任医师,E-mail:pingyanlaoto@163.com
基金资助:
上海市卫生局科研课题(20124122)

Analysis of the possible causes of endodontic treatment failure by inspection during apical microsurgery treatment

QIAN Wen-hao¹,HONG Jin²,XU Pei-cheng¹

1.Shanghai Xuhui District Dental Center. Shanghai 200032;
2. Department of First Dental Clinic, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2014-06-18 Online:2015-04-20 Published:2015-07-24
Supported by:
Science and Technology Research Project from Shanghai Municipal Public Health Bureau (20124122)

摘要/Abstract

摘要： 目的通过显微根尖手术直接探查,分析以往根管治疗失败的可能原因。方法收集2006年1月—2014年1月因根管治疗失败需行根尖手术的患牙289颗,其中238个牙根被纳入研究。所有根尖手术都在显微镜下完成,手术过程中将被切除的根尖或牙根断面进行亚甲蓝染色后,放大26倍,观察先前的根管治疗情况。采用SPSS19.0软件包,应用Fisher精确检验法进行统计学处理。结果在238个牙根的根尖手术病例中,根管治疗失败的可能原因包括根管渗漏（29.41%）、遗漏根管（15.55%）、根管欠充（15.55%）、根尖部解剖结构复杂（7.98%）、根管超充（4.20%）、根尖骨开窗（4.20%）、医源性因素（3.36%）、根尖结石（2.52%）、根尖裂纹（1.68%）和未知原因（15.55%）,根管治疗失败的发生率在不同牙位差异显著（P<0.001）。结论显微根尖手术能更好地探查根管治疗失败的可能原因,为提高根管治疗成功率提供保障。

关键词: 显微根尖手术, 根管治疗, 失败原因

Abstract: PURPOSE: To analyze the possible causes of previous endodontic treatment failure by microscopic inspection during apical microsurgery. METHODS: Two hundred and eighty-nine teeth of previous endodontic treatment failure were collected from patients in Shanghai Xuhui District Dental Center, between January 2006 and January 2014. All surgical procedures were performed by using an operating microscope, and 238 roots were included in the study. The surface of the apical root to be resected or the resected root surface after methylene blue staining was examined during the surgical procedure and inspected with 26 magnification to determine the state of the previous endodontic treatment by using an operating microscope. Fisher's exact test was used to analyze the data with SPSS 19.0 software package. RESULTS: Among the 238 roots with periapical surgery, analysis of the reasons for previous endodontic treatment failure included leaky canal (29.41%), missing canal (15.55%), underfilling (15.55%), anatomical complexity (7.98%), overfilling (4.20%), apical fenestration (4.20%), iatrogenic problem (3.36%), apical calculus (2.52%), apical cracks (1.68%) and unknown reasons (15.55%). The frequency of possible failure causes and tooth position were closely correlated (P<0.001). CONCLUSIONS: Apical microsurgery can better inspect possible causes of previous endodontic treatment failure, in order to improve the success rate of endodontic treatment.

Key words: Apical microsurgery, Endodontic treatment, Cause of failure

中图分类号:

R781.05

钱文昊,洪瑾,徐培成. 显微根尖手术探查根管治疗失败的可能原因分析[J]. 上海口腔医学, 2015, 24(2): 206-209.

QIAN Wen-hao,HONG Jin,XU Pei-cheng. Analysis of the possible causes of endodontic treatment failure by inspection during apical microsurgery treatment[J]. Shanghai Journal of Stomatology, 2015, 24(2): 206-209.

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