显微根尖手术的全周期管理

Full-cycle management of endodontic microsurgery

显微根尖手术是实现疑难根尖周病患牙保存的有效手段。本文提出显微根尖手术的全周期管理理念,针对患者的全身情况和患牙的局部特点制定全面的检查、治疗和复查方案,以达到预期手术疗效,有效保留天然牙。全周期管理包括术前通过对患者的全身评估和口腔术区评估,针对患牙情况选择合适方法进行显微根尖手术;术中应用激光技术、骨窗技术、动静态导航等技术手段,使术式设计多样化,手术更趋于精细、微创;术后根据病史、临床表现及影像学标准评定治疗效果,并对近远期疗效进行解读。

Contemporary endodontic microsurgery has emerged as a significant treatment modality in the retention of teeth with persistent apical periodontitis.This article proposes the concept of the full-cycle clinical management of endodontic microsurgery based on the condition of the patient and tooth,attempting to develop a comprehensive strategy for the examination,treatment and follow-up to save natural teeth.Full-cycle clinical management included preoperative consideration of the general condition and surgical site and selection of cases for endodontic microsurgery;intraoperative application of techniques such as lasers,"bone window"technique and targeted endodontic microsurgery to make the surgical approaches more varied and the operation minimally invasive;postoperative outcome assessment according to the history,clinical and radiographic examination;and analysis of the short-and long-term outcomes.