临床口腔医学杂志
臨床口腔醫學雜誌
림상구강의학잡지
Journal of Clinical Stomatology
2015年
9期
568-570,571
,共4页
显微超声技术%CBCT%上颌第一磨牙%MB2根管%根管再治疗
顯微超聲技術%CBCT%上頜第一磨牙%MB2根管%根管再治療
현미초성기술%CBCT%상합제일마아%MB2근관%근관재치료
dental operating microscope%cone-beam computed tomography%maxillary first molar%second mesiobuc-cal canal%endodontic retreatment
目的：分析应用显微超声技术结合CBCT检查对上颌第一磨牙MB2根管再治疗的临床效果。方法：选择89颗上颌第一磨牙进行显微超声根管再治疗病例，将CBCT的检查结果作为金标准，并依据CBCT影像特征及牙冠与髓底的形态特点判断是否存在MB2，术中采用斜方形开髓入口，小号K锉探查，使用手术显微镜定位MB2根管，镍钛机用根管锉冠向下法预备根管，1．5％次氯酸钠和17％EDTA冲洗根管系统，采用热牙胶垂直加压充填根管，记录近颊根根管分型、根管预备过程中并发症的情况，统计MB2的发现率及根管形态，评价其临床疗效。结果：89颗患牙根管再治疗中，在根管显微镜下去除原根管充填物，并探查MB2，发现MB272个。发现率为80．89％（72／89），疏通61个，疏通率68．54％。近颊根双根管以2－1型、2－2型较常见（67．42％）。治疗过程中未发生器械折断、管壁侧穿等并发症，有8个根管超填，6个根管欠填。结论：上颌第一磨牙MB2的发生率高，多数根管细小弯曲，小号K锉配合EDTA疏通根管，应用显微超声技术结合CBCT探查，有意识地寻找和可视化操作，能有效地提高上颌第一磨牙MB2的发现率及根管治疗成功率。
目的：分析應用顯微超聲技術結閤CBCT檢查對上頜第一磨牙MB2根管再治療的臨床效果。方法：選擇89顆上頜第一磨牙進行顯微超聲根管再治療病例，將CBCT的檢查結果作為金標準，併依據CBCT影像特徵及牙冠與髓底的形態特點判斷是否存在MB2，術中採用斜方形開髓入口，小號K銼探查，使用手術顯微鏡定位MB2根管，鎳鈦機用根管銼冠嚮下法預備根管，1．5％次氯痠鈉和17％EDTA遲洗根管繫統，採用熱牙膠垂直加壓充填根管，記錄近頰根根管分型、根管預備過程中併髮癥的情況，統計MB2的髮現率及根管形態，評價其臨床療效。結果：89顆患牙根管再治療中，在根管顯微鏡下去除原根管充填物，併探查MB2，髮現MB272箇。髮現率為80．89％（72／89），疏通61箇，疏通率68．54％。近頰根雙根管以2－1型、2－2型較常見（67．42％）。治療過程中未髮生器械摺斷、管壁側穿等併髮癥，有8箇根管超填，6箇根管欠填。結論：上頜第一磨牙MB2的髮生率高，多數根管細小彎麯，小號K銼配閤EDTA疏通根管，應用顯微超聲技術結閤CBCT探查，有意識地尋找和可視化操作，能有效地提高上頜第一磨牙MB2的髮現率及根管治療成功率。
목적：분석응용현미초성기술결합CBCT검사대상합제일마아MB2근관재치료적림상효과。방법：선택89과상합제일마아진행현미초성근관재치료병례，장CBCT적검사결과작위금표준，병의거CBCT영상특정급아관여수저적형태특점판단시부존재MB2，술중채용사방형개수입구，소호K촤탐사，사용수술현미경정위MB2근관，얼태궤용근관촤관향하법예비근관，1．5％차록산납화17％EDTA충세근관계통，채용열아효수직가압충전근관，기록근협근근관분형、근관예비과정중병발증적정황，통계MB2적발현솔급근관형태，평개기림상료효。결과：89과환아근관재치료중，재근관현미경하거제원근관충전물，병탐사MB2，발현MB272개。발현솔위80．89％（72／89），소통61개，소통솔68．54％。근협근쌍근관이2－1형、2－2형교상견（67．42％）。치료과정중미발생기계절단、관벽측천등병발증，유8개근관초전，6개근관흠전。결론：상합제일마아MB2적발생솔고，다수근관세소만곡，소호K촤배합EDTA소통근관，응용현미초성기술결합CBCT탐사，유의식지심조화가시화조작，능유효지제고상합제일마아MB2적발현솔급근관치료성공솔。
Objective:To observe the clinical feature and evaluate clinical treatment effect of second mesiobuccal canals (MB2 canal) of maxilarry first molars missed in initial endodontic treatment using cone-beam computed tomography (CBCT) and dental operating microscope (DOM). Method:The root canals of 89 maxillary first molars which need en-dodontic retreatment were selected. The existence of MB2 canal was determined by radiographs and anatomic features of crown and pulpal floor. With a thapezium path to pulp chamber,the MB2 canals were explored by a small size K file and located using a DOM when needed. The canals were instrumented by Ni-Ti rotary instruments,irrigated by 1.5 % NaOCI and 17 % EDTA were obturated by lateral condensation and vertical compaction technique. The type of mesiobuccal root canals,the in-operative complications and the obturation effect were record. Result:The frequency of MB2 canal in maxil-lary first molar was 80.89 %(72/89) in endodontic retreatment while negotiate rate was 68.54 %. most of them were fine and curved which were negotiated with small size files and EDTA. 2-1 type and 2-2 type were the main type of mesiobuc-cal root canals(67.42%). There were no obvious complications during operation. Conclusion:The incidence of MB2 canals in maxillary first molars was high,and most of them were fine and curved. The MB2 canals can be negotiated with small size file and EDTA,Most of MB2 canals were fine,curved and concealed. The management of searching for MB2 canals and the increased visibility afforded with the use of DOM can make the treatment more successful.
