手术显微镜在疑难根管治疗中的应用

The use of the operating microscope in complicated root canal treatment

近15年来,影响根管治疗质量的最重要因素之一就是手术显微镜的引入和推广应用。手术显微镜多级放大功能和良好的照明技术,使医生能够看清髓室底及根管内部结构,精确定位手术位置,把握操作细节,从而改善并提高根管治疗术的质量。显微根管治疗可以对传统根管治疗无法完成或难以完成的病例包括根管遗漏、塑化根管、钙化根管、根管台阶形成、器械断针、侧壁穿孔等进行治疗,使更多患牙得以保留。本文结合笔者的临床经验及国内外文献,对根管手术显微镜的组成、显微治疗辅助设备器械的功能和显微镜在疑难根管治疗中的应用等进行评述。强调根管显微镜在疑难病例治疗中的重要性和必要性,并提出在进行显微根管治疗前须进行显微镜应用技巧培训。

The most important revolution in the last 15 years, particularly in endodontics, has been the introduction and widespread adoption of the operating microscope. The microscope allowed clinicians to see better, feel better, and think better. In addition to facilitating finding canals, the microscope also has improved endodontic outcomes in diagnosis, predictability, tooth conservation, and location of additional canals. This paper, based on the authors＇ experience and relevant literature, summarized the composition of microscope and introduction of microinstruments, as well as the importance of microscope in complicated root canal treatment, such as locating hidden canals, removing the resinfying materials in canals , management of calcified canals and the ledge, retrieval of broken files and perforation repair. To address the efficiency issue, clinicians should take an intensive training course at the very beginning to make them comfortable with handing the microscope and with working underneath it.