显微超声技术处理钙化根管的临床效果评价

Evaluation on managing calcified root canals with ultrasonic technique under dental operating microscope

目的评价牙科显微镜结合超声技术处理钙化根管的临床疗效。方法牙髓炎或根尖周炎患者61例,患牙75颗,需进行根管治疗的钙化根管共89个,在显微镜下采用超声器械清除钙化组织,用8号K锉或C型先锋锉辅助乙二胺四乙酸凝胶疏通根管,记录钙化根管疏通成功率及失败情况。结果 89个钙化根管成功疏通67个,成功率为75.3%。前牙成功率为94.1%,前磨牙成功率为76.7%,磨牙成功率为48.0%;前牙和前磨牙之间(χ2=4.016,P<0.05),前磨牙和磨牙之间(χ2=4.843,P<0.05)成功率差异有统计学意义。根管上1/3钙化根管的疏通成功率为91.9%,根管中1/3为79.3%,根管下1/3为43.5%,根上1/3与根中1/3之间成功率差异无统计学意义(χ2=2.185,P>0.05),根中1/3与根下1/3之间差异有统计学意义(χ2=7.102,P<0.05)。结论显微超声技术是处理钙化根管的一种安全有效的方法,但在处理磨牙根管下1/3钙化时有很大局限性。

Objective To evaluate the effect of managing calcified root canals with ultrasonic technique under dental operating microscope. Methods Eighty-nine calcified root canals of 75 teeth from 61 patients were negotiated with ultra- sonic root canal technique under operating microscope, combined with using small size C-Pilot files and EDTA. The num- ber of successfully negociated canals and the failure canals were recorded. Results Sixty-seven calcified root canals were negotiated, enlarged and obturated. The success rate was 75.3%. The success rate of anterior teeth and calcified coronal canals was higher than that of posterior teeth and calcified apical canals. Conclusion The use of ultrasonic canal technique with dental operating microscope is effective in management of calcified root canals. However, the management of calcified apical or curved canals especially in mandibular molars is not encouraged.