硬化牙本质的发生、特征及应对策略

Occurrence,characteristics and management of sclerotic dentin

硬化牙本质是由于牙本质小管内矿物质沉积而阻塞的结果,且阻塞物阻射率与正常牙本质相似。随着年龄的增长,当根尖区存在硬化牙本质时,根管难以疏通。牙科手术显微镜、超声器械及锥形束CT的应用大大提高了存在硬化的根管治疗的成功率,但对于硬化牙本质的处理至今尚无明确合理的最优策略。文章将针对硬化牙本质的发生、特征及应对策略做一介绍,以期为临床治疗疑难根尖周病提供参考。

Sclerosis is the result of occlusion of dentinal tubules by a mineral substance with a refractive index similar to that of the normal dentin. With age increasing,it′s difficult to negotiate root canal when there is sclerotic dentin in apical area. The application of dental operating microscope(DOM),ultrasonic instrument and cone beam computed tomography(CBCT)has greatly improved the success rate of treatment for root canal with sclerosis. There was still no explicit and logical optimal strategy for sclerotic dentin. This article aims to introduce the occurrence,characteristics and management of sclerotic dentin in order to provide new ideas for clinical treatment of refractory periapical disease.