显微超声技术在钙化根管治疗中的临床研究

Root canal therapy of calcified teeth with dental operating microscope and ultrasonic instruments

目的:评价根管显微镜联合超声技术在钙化根管治疗中的应用。方法:选取临床上常规方法根管预备失败的钙化根管患牙42颗,钙化根管91个,在根管显微镜下,采用超声根管锉疏通钙化根管上段,再用小号手用K锉(08#和10#)和15%EDTA疏通根管中下段,机用镍钛ProTaper完成根管预备,热牙胶完成根管充填,观察并评价疗效。结果:75个钙化根管疏通成功并完成根管充填,根管疏通率82.41%,治疗过程中有1例根管侧壁穿孔,2例出现根尖偏移,其余病例无根折、无根管台阶形成,无器械折断。结论:对于根管中上段钙化的根管,根管显微镜可提供良好的光源和清晰的术野,超声器械可有效地去除钙化组织,但对于根尖1/3的弯曲钙化根管则容易造成根管侧壁穿孔或台阶形成。

Objective：To evaluate the effect of dental operating microscope and ultrasonic instruments in the management of calcified root canals.Method：42 teeth that had been treared with convention repaired before were selected for root canal therapy.The coronal portion of calcified root canals were negotiated with ultrasonic instruments under dental operating microscope,and the apical portion was managed with small size 08#、10# hand fills and 15 % EDTA.The root canal of all cases were shaped by Nickel-Titanium rotary instruments ProTaper,and obturated with vertical condensation technique.The efficient of preparation and obturation was analyzed by radiographs before and after treatment.Result：The 75 root canals of 91 calcified root canals were enlarged and obturated,with a success rate of 82.41 %,there was one root perforation and two root canals defection during the therapeutic process.Conclusion：The use of dental operating microscope and ultrasonic instruments is proved effective in negotiation of coronal portion of calcified root canals.Nevertheless,the use of ultrasonic instruments in apical or curved portion of canal is not encouraged.