下颌前牙和前磨牙根管遗漏治疗失败的临床分析

Clinical analysis of treatment failure of canal missed in mandibular anterior teeth and premolars

目的探讨下颌前牙、前磨牙根管遗漏治疗失败的原因。提高根管治疗的成功率。方法选择2003～2006年口腔门诊的33例下颌前牙、前磨牙治疗后疼痛的病例,进行术前、术后的X线正位、偏位投照,配合根管显微镜的应用,寻找确定双根管。结果33例患者41颗下颌前牙、前磨牙治疗后疼痛,因根管遗漏而导致治疗失败。结论根管遗漏是导致下前牙,下前磨牙治疗失败的原因之一,采用正位、偏位角度的术前、术后及诊断丝X线片投照,配合根管显微镜的使用,有助于双根管的发现,避免根管遗漏。

Objective To investigate the failure causation of the clinical detection and treatment of multiple canals of mandibular anterior teeth and premolars. Methods Thirty-three cases of difficult root canal therapeutic were studied with the hdp of a surgical microscope from 2003 to 2006. Four kinds of radiographs were taken for each tooth. The radiographs were taken at horizontal angles from the medial or distal of the tooth with and without files in canals. Results The treatment of 41 mandibular anterior teeth and premolars of 33 patients was of failure. The failure causation was the canal missed. Conclusions The different-angle projection technique will assist the clinician in the detection and treatment of multiple canals of mandibular anterior teeth and premolar, and the angle projection technique with file detects more multiple canals. Dentists should know well of the morphology of canals and adequate access, and choose proper instruments.