显微根管技术用于失败根管再治疗的临床研究

Clinical efficacy of microscopic root canal technique for failed root canal retreatment

目的探讨显微根管技术用于失败根管再治疗的临床效果。方法因修复需要进行根管再治疗患者102例(118颗牙,156个根管)分为观察组(51例、60颗牙,78个根管)和对照组(51例、58颗牙,78个根管)。观察组采用超声根管锉治疗,对照组未在显微镜下进行治疗。根管再治疗3个月后复查,进行疗效评价,观察根管填充程度和疼痛程度。结果观察组78个根管中66个实现再通,成功率为84.62%;对照组78个根管中53个实现再通,成功率为67.95%;两组上颌前磨牙、下颌前磨牙、上颌磨牙、下颌磨牙以及总根管再通成功率比较差异均有统计学意义(P<0.05)。观察组和对照组根管填充恰填比例分别为84.62%和71.79%,差异有统计学意义(P<0.05);观察组疼痛程度略低于对照组,但差异无统计学意义(P>0.05)。结论显微根管技术能有效提高根管再治疗的成功率,降低根管填充欠填和超填比例,值得临床推荐。

Objective To evaluate the clinical efficacy of microscopic root canal technique for retreatment of failed root canals. Methods Firstly, 102 patients (118 teeth, 156 root canals) admitted for root canal retreatment were divided into an experimental group (51 patients, 60 teeth, 78 root canals) and a control group (51 patients, 58 teeth, 78 root canals). The experimental group was subjected to ultrasound root canal treatment while the control group was not treated under the microscope. The root canals were re-examined 3 months after treatment for review and efficacy evaluation. The degree of root canal filling and the degree of pain in the wake of treatment were then assessed. Results 66 of the 78 root canals in the experimental group were found to have been recanalized, the success rate being 84.62%. 53 of the 78 root canals in the control group were found to have been recanalized, the success rate being 67.95%. The differences between the groups in the rates of success in recanalizing the roots of maxillary premolars, mandibular premolars, maxillary molars, mandibular molars and in the rates of total root canal recanalization were statistically significant ( P <0.05). The proportions of proper root canal filling in the experimental group and the control were 84.62% and 71.79% respectively. The difference was statistically significant ( P <0.05). The pain level of the experimental group was slightly lower than that of the control group, the difference being not statistically significant ( P >0.05). Conclusions Microscopic root canal technique can effectively improve the success rate of root canal retreatment and reduce the rates of underfilling and overfilling, and thus can serve as a desirable technique for failed root canals retreatment.