根管再治疗的原因及临床操作难点分析

Survey of the cause of endodontic revision and the difficulty of clinical management

目的 :探讨根管再治疗的原因及临床操作之难点。方法 :对 2 0 0 0年 2月～ 2 0 0 3年 8月间就诊的 192人2 16颗需根管再治疗的患牙资料进行了原因及临床操作难点分析。结果 :原治疗为根管充填的有 15 8颗 ,均表现为欠填 ,其中有根尖阴影者 97颗。原治疗为塑化治疗的有 5 8颗 ,其中有根尖阴影者 38颗。遗漏根管是磨牙治疗失败的重要原因之一。结论 :根管治疗失败后 ,进行根管再治疗是切实有效的。上颌第一磨牙近中颊根的第二根管及下颌第二磨牙远中舌侧根管容易遗漏 ,治疗难度大 。

Objective:To survey the cause of endodontic revision and the difficulty of clinical management.Methods:The data of 216 teeth (192 patients) which received endodontic revision during 2000～2003 were studied on the cause of endodontic revision and the difficulty of clinical management.Results:All of 158 teeth with root canal filling originally were underfilled, and 97 teeth of them showed periapical lesion.The 38 of 58 teeth with pulp resinifying therapy originally showed periapical lesion. Missing of the root canal was one of the important causes for endodontic failure in molar.Conclusion:Endodontic revision was feasible for the management of endodontic failure.High attention should be paid to the second canal of the medial-buccal root of upper first molar and the distal-lingual canal of lower second molar,which were overlooked usually and difficult for endodontic revision.