利用根管显微镜诊治恒牙变异根管的临床疗效

Diagnosis and Treatment of Permanent Teeth with Canal Varieties Using Dental Operating Microscope

目的:评价运用根管手术显微镜和超声技术诊治成人恒牙变异根管的临床疗效。方法:选择需行显微根管治疗的恒牙97颗,在根管手术显微镜下诊断、定位变异根管,机用镍钛旋转器械冠向下法预备根管,热牙胶垂直加压技术充填根管。记录根管变异类型,治疗过程中并发症情况,统计成功率。结果:97颗含有变异根管的患牙波及下颌前牙区、前磨牙区、磨牙区和上颌磨牙区。上颌磨牙区根管变异的主要类型为近颊根双根管,其中2-2型根管多见;下颌第二磨牙根管变异以C形根管为主,C2型根管多见。91颗患牙治疗成功,成功率为93.81%。无一例发生根管壁侧穿或牙根折裂。结论:成人恒牙根管系统的复杂变异是临床诊治的难点,运用现代治疗技术寻找和定位变异根管是治疗成功的关键,根管手术显微镜对提高变异根管的诊治成功率具有重要价值。

Objective：To evaluate the use of dental operating microscope （DOM） in diagnosis and treatment of the permanent teeth with canal varieties. Methods：97 teeth with anatomic variation were selected. In the root canal therapy,DOM was applied in the process of examination of canal varieties,location of root canal orifice,canal preparation by motor rotated Ni-Ti and canal obturation with warm vertical compaction technique. The type of canal varieties,the in-operative complications and success rate were record. Results：97 teeth with anatomic variation included mandibular anteriors,premolars,molars and maxillary molars. In maxillary molars,two canals in mesiobuccal root was the main type of variety while 2-2 type canals had a high incidence in this root. C-shaped canal was the main variety type in mandibular second molars while C2 type canals had a high incidence. 91 teeth were successfully managed with a success rate of 93.81%. Complications such as root canal perforation or vertical fracture did not occur. Conclusion：The complicated varieties in root canal made the endodontic treatment more difficult. The management of locating variant canals should be done with the help of comtemporary endodontic technique. The DOM was a valuable tool in endodontic diagnosis and treatment of variant canals.