牙髓塑化治疗失败原因临床分析

Clinical analysis on associated failure reasons of resinifying therapy for dental pulp

目的通过对牙髓塑化治疗失败需再治疗的患牙进行分析，探讨其失败原因。方法选取178颗塑化治疗失败牙，根据初次治疗情况、临床、术前X线根尖片等检查资料及术中对患牙根管系统的探查等判断治疗失败原因。结果患牙牙位分布情况：上下颌磨牙共139颗（78．1％），上颌磨牙发生率最高（51．7％）;牙折发生率最高，共97颗（54．5％），根尖周炎、残髓炎的患牙共69颗（38．8％）;失败牙中多存在塑化不全或根管遗漏。结论塑化治疗失败牙多发于磨牙，特别是上颌磨牙，失败最主要原因为牙折，其次为残髓炎及根尖周病变。

Objective To analyze the failed causes of resinfying therapy for dental pulp. Methods 178 failed resinfying teeth were analyzed according to the initial treatment records, clinical examination, pretreatment radiographs, and root canal exploration during retreatment. Results The distribution of the 178 failed teeth： the failed resiufying teeth occurred molar mostly （ 78.1% ）, especially on maxillary molar （ 51.7% ）; and the main cause of failure of resinfying therapy involved teeth fracture（ 54.5% ）, the second main causes were periapical periodontitis and resdin pulpitis, and most failed teeth were identified inadequate redsinfying operation or missing root canal. Conclusions The failed teeth of resinfying therapy occurres molar mostly, especially on maxillary molar, the main cause of failure of resinfying therapy is teeth fracture, and the second causes are periapical periodontitis and resdin pulpitis.