感染根管的治疗难点和对策

Strategies of endodontic infection control

微生物感染是牙髓根尖周疾病发生和发展的根本原因,也是根管治疗失败的罪魁祸首。因此彻底清除根管系统内的感染物质,预防根管系统再感染,是保证根管治疗成功与否的关键。在临床根管治疗过程中,口腔环境定植细菌种类的多样性、牙髓组织环境的特殊性、根管系统解剖的复杂性以及治疗方法的局限性,使得预防口腔微生物对根管系统的污染以及感染根管内微生物的彻底清除困难重重。根管治疗过程中患牙的严密隔离,根管预备技术的合理选择,根管预备器械的灵活使用,根管冲洗的有效应用,诊间根管封药的正确选用,以及根管充填的三维封闭,遵循感染根管治疗的操作规程,可以最大限度地保证感染根管的临床治疗效果。

Microbe infection is not only the key pathogenic factor of primary endodontic infectious diseases,but also the arch-crimina of endodontic treatment fail.Therefore,the endodontic treatment success is based on the debridement of infectious root canal,elimination of bacteria,and the prevention of endodontic reinfection.It is beset with difficulties to control the endodontic infection in clinic because of the bacterial variety,anatomic complexity of root canal,and limitation of the root canal therapeutic methods.In order to get the ideal prognosis of the root canal treatment,in the procedure of the therapy,it should be the tight isolation of tooth,reasonable choose of the root canal preparation technique,rational use of root canal preparation instrument,effective irrigation of root canal,proper root canal dressing,and the 3-dimensional obturation of root canal.