根管显微镜下应用超声技术去除根管内金属异物47例疗效分析

Effect analysis of microsonic technique to remove fractured metallic instruments from root canals

目的评价在根管显微镜下应用超声技术取出根管内异物的临床效果。方法对中国医科大学口腔医学院牙体牙髓科2006年3月至2007年11月因根管内异物就诊的47例患者,在根管显微镜观察下使用GG钻或超声工作尖制备距异物的直线通路,用超声工作尖ET20、ET40、K15对47例根管内金属异物进行处理。结果47例金属异物成功取出40例并完善根管治疗,其中裂钻1例;拔髓针2例;根管内断桩4例;不锈钢锉14例;不锈钢扩大针17例;protaper2例。失败7例,其中2例未找到异物;2例出现根管壁穿孔;3例放弃治疗。总取出率为85.1%。结论应用根管显微镜可以准确观察金属异物在根管内的部位、松动度、周围组织情况等,因此可以避免操作时的盲目性,有助于异物取出并最大限度减少根管壁牙本质的切削量和根管壁穿孔的概率;根管显微镜下应用超声技术取出根管内金属异物的方法安全有效,值得临床上推广应用。

Objective To evaluate the clinical effect of microsonic technique on removal of fractured metallic instuments from root canals.Methods 47 fractured metallic instruments were endodontically managed with ultrasonic tips and Gates Glidden bur under dental operating microscope,The success rate was calculated by the cases which could be perfectly done root canal obturation after fractured metallic instruments removal accomplished.Results 40 of 47 fractured metallic instruments were perfectly removed with a success rate of 85.1%.Conclusion The ultrasonic technique combined with dental operating microscope is an effective and safely method of fractured metallic instruments removal,therefore,worth clinical application.