干髓术失败患牙的根管再治疗

Root canal treatment of teeth with pulp mummification

目的:通过对干髓术失败患牙进行根管再治疗,探讨此类病例的特点及再治疗方法.方法:选取干髓术失败的磨牙63个,采用小号K锉配合次氯酸钠溶液和EDTA溶液探查根管并清理根管内的感染物质,封入氢氧化钙糊剂1～2周,采用机动镍钛器械Hero642进行根管预备,侧向加压技术充填根管,记录治疗过程中患牙症状的改善程度,根管疏通情况,根管预备和充填的效果.结果:62个患牙的根管疏通成功,治疗过程中症状明显缓解或完全消失,瘘管明显减小或消失,根管预备时无根管偏移、根尖阻塞、台阶等并发症发生,根管形态良好.结论:干髓术失败患牙在根管治疗时强调彻底清除根管内的感染物质,采用次氯酸钠和EDTA溶液清理根管,氢氧化钙消毒根管,机用镍钛器械进行根管预备能取得良好的治疗效果.

Objective：To discuss the clinical feature and endodontic retreatment technique of teeth with pulp mummification. Method-63 molars that had treated with pulp mummification were selected for root canal therapy. The root canals were explored with small size K files combined with NaOCl and EDTA. The calcium hydroxide was then used as intracanal dressing for one to two weeks. The root canals of all cases were instrumented by Ni-Ti rotary instruments Hero 642, and obturated with lateral condensation technique. The change of symptom and negotiation of root canal system were recorded, and the efficiency of preparation and obturation was analyzed with radiographs before and after treatment. Resuit： The root canals of 62 teeth were negotiated successfully, of which symptoms were improved obviously. No complication, such as transportation, ledge or blockage, was found. Good result of treatment was achieved in the 62 cases. Conclusion：Debridement of irffected root canals of mummified teeth should be reinforced by means of irrigation with NaOCl and EDTA, and medication with calcium hydroxide. With Ni-Ti rotary instrumentation of root canal system after negotiation, the mummified teeth can be retreated very well.